Provider Demographics
NPI:1346911237
Name:SLAWTER, RANDI (PA-C)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:SLAWTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RANDI
Other - Middle Name:
Other - Last Name:MIELKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1119 W WARN WAY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6243
Mailing Address - Country:US
Mailing Address - Phone:425-791-2031
Mailing Address - Fax:
Practice Address - Street 1:400 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1334
Practice Address - Country:US
Practice Address - Phone:509-838-2531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
WAPA61186369363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant