Provider Demographics
NPI:1073387619
Name:MARSHALL, RANDI JO (RN00167251)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:JO
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:RN00167251
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 LOWER SUNNYSLOPE RD
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-9614
Mailing Address - Country:US
Mailing Address - Phone:509-670-7216
Mailing Address - Fax:
Practice Address - Street 1:731 N CHELAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2026
Practice Address - Country:US
Practice Address - Phone:509-433-3700
Practice Address - Fax:509-433-3762
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00167251163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse