Provider Demographics
NPI:1477677177
Name:RANDLE, DENNIS STEVEN (DIPL AC MAC LAC)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:STEVEN
Last Name:RANDLE
Suffix:
Gender:M
Credentials:DIPL AC MAC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3905 SUMMITVIEW AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902
Mailing Address - Country:US
Mailing Address - Phone:509-965-6751
Mailing Address - Fax:509-965-9868
Practice Address - Street 1:3905 SUMMITVIEW AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:509-965-6751
Practice Address - Fax:509-965-9868
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000296171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist