CHARLES D RANDOLPH (NPI# 1760040281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760040281 |
| Entity Type | Individual |
| Full Name | CHARLES D RANDOLPH |
| Credential | MD |
| Practice Address |
3915 Talbot Rd S Ste 401 Renton WA 98055-5738 |
| Practice Telephone | 4256903445 |
| Practice Fax Number | 4256909445 |
| Mailing Telephone | 4256903445 |
| Mailing Fax Number | 4256909445 |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164589107 | Charles D Randolph | Dentist | 875 Mamaroneck Ave, Suite 302, Mamaroneck, NY 10543-1900 | 2007-01-02 |
| Street Address |
3915 TALBOT RD S STE 401 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619930088 | Richard O Avalon | Family Medicine | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2006-04-07 |
| 1609491463 | Brian Coombs Ostler | Student in an Organized Health Care Education/Training Program | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2020-06-08 |
| 1437773330 | Leah Sage Foley | Family Medicine | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2020-06-05 |
| 1619591526 | Maryam Sabetian | Family Medicine | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2020-06-05 |
| 1851915755 | Jacqueline Marie Hendrix | Family Medicine | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2020-06-05 |
| 1871117754 | Soumya Choudhury | Family Medicine | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2020-06-05 |
| 1053979526 | Brittany Michelle Buescher | Student in an Organized Health Care Education/Training Program | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2019-05-30 |
| 1548828056 | Daniel Christian Bernet | Student in an Organized Health Care Education/Training Program | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2019-05-30 |
| 1023676541 | Brandi Jo Boden | Student in an Organized Health Care Education/Training Program | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2019-05-30 |
| 1063070530 | Matthew Julian Duenas | Student in an Organized Health Care Education/Training Program | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2019-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252252 | Kevin Do | Student in an Organized Health Care Education/Training Program | 877 Jericho Pl Ne, Renton, WA 98059-4472 | 2020-07-16 |
| 1043856628 | Megan Ramaiya | Student in an Organized Health Care Education/Training Program | King Count Sexual Assault & Resource Center, 200 Mill Ave S # 10, Renton, WA 98057 | 2019-11-19 |
| 1154985174 | Christine Tran Vu | Student in an Organized Health Care Education/Training Program | 11912 Se 175th St Apt F202, Renton, WA 98058-6067 | 2019-04-25 |
| 1790260404 | Alexandra Iani | Student in an Organized Health Care Education/Training Program | 707 S Grady Way Ste 300, Renton, WA 98057-3245 | 2018-09-27 |
| 1417489345 | Hanson Mouanoutoua | Student in an Organized Health Care Education/Training Program | 15205 140th Way Se, K303, Renton, WA 98058-7846 | 2017-03-30 |
| 1245761865 | Paul Minnich | Student in an Organized Health Care Education/Training Program | 14012 163rd Pl Se, Renton, WA 98059-3662 | 2017-03-24 |
| 1386241628 | Meaghan Ferrick | Student in an Organized Health Care Education/Training Program | 707 S Grady Way Ste 300, Renton, WA 98057-3245 | 2020-10-08 |
| 1124644356 | Alexandra Jordan Henry | Student in an Organized Health Care Education/Training Program | 707 S Grady Way, Renton, WA 98057-3224 | 2020-06-23 |
| 1609491463 | Brian Coombs Ostler | Student in an Organized Health Care Education/Training Program | 3915 Talbot Rd S Ste 401, Renton, WA 98055-5738 | 2020-06-08 |
| 1851912802 | Amy Lee | Student in an Organized Health Care Education/Training Program | 955 Powell Ave Sw, Renton, WA 98057-2908 | 2020-04-30 |
| Find all providers in RENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.