Provider Demographics
NPI:1477569630
Name:SINGH, RANDIP (MD)
Entity Type:Individual
Prefix:
First Name:RANDIP
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5845
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97228-5845
Mailing Address - Country:US
Mailing Address - Phone:425-454-5281
Mailing Address - Fax:425-990-5261
Practice Address - Street 1:1100 112TH AVE NE
Practice Address - Street 2:SUITE 320
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4511
Practice Address - Country:US
Practice Address - Phone:425-289-3000
Practice Address - Fax:425-289-3240
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000458612084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8857881Medicare PIN