RANDOLPH OTTO (NPI# 1881767606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881767606 |
| Entity Type | Individual |
| Full Name | RANDOLPH OTTO |
| Credential | MD |
| Practice Address |
2202 S Cedar St Ste 200 Tacoma WA 98405-2318 |
| Mailing Address |
3402 S 18th St Tacoma WA 98405-1903 |
| Practice Telephone | 2533831099 |
| Practice Fax Number | 2533833919 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
00027380 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8125395 | 05 |
| Street Address |
2202 S CEDAR ST STE 200 |
| City | TACOMA |
| State | WA |
| Zip Code | 98405-2318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700959772 | William Jackson | Radiology | 2202 S Cedar St Ste 200, Tacoma, WA 98405-2318 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
| 1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| Find all providers in zip 98405 | ||||
| Taxonomy Code | 2085P0229X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Pediatric Radiology |
| A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710956909 | Neris Milagros Nieves-robbins | Radiology | Madigan Us Army Medical Center Radiology Mchj-dr, Bldg 9040 Fitzsimmons Drive Fort Lewis, Tacoma, WA 98431-0001 | 2006-03-17 |
| 1235541285 | Kathleen Michelle Boyer | Radiology | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2014-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093378929 | Murat Alp Oztek | Radiology | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2019-04-16 |
| 1710393541 | Sakura M Noda | Radiology | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2014-07-01 |
| 1053758524 | Mahesh G. Atluri | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2013-05-23 |
| 1265875504 | Erin K Romberg | Radiology | 4800 Sand Point Way Ne, Seattle, WA 98105 | 2013-04-16 |
| 1295094266 | Ezekiel Maloney | Radiology | 1959 Ne Pacific St, Box 357115, Seattle, WA 98195-7115 | 2012-05-11 |
| 1164714408 | Garland H Mcquinn | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2011-05-04 |
| 1932491495 | Andrew Christian Olson | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2011-05-03 |
| 1942590757 | Harry Nelson Conley Iv | Radiology | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2011-04-13 |
| 1770896235 | Sarah Joy Menashe | Radiology | 19020 33rd Ave W, Suite 210, Lynnwood, WA 98036-4748 | 2010-07-26 |
| 1083857817 | Kristine Emaline Andrade | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2009-04-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RANDOLPH OTTO.
| 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.