Provider Demographics
NPI:1063650760
Name:ROMERO, RANDY E (RRT)
Entity Type:Individual
Prefix:MR
First Name:RANDY
Middle Name:E
Last Name:ROMERO
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 HONEYCUTT DR
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-9114
Mailing Address - Country:US
Mailing Address - Phone:541-773-1554
Mailing Address - Fax:
Practice Address - Street 1:511 HONEYCUTT DR
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-9114
Practice Address - Country:US
Practice Address - Phone:541-773-1554
Practice Address - Fax:877-274-8848
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRT-P-10125607227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered