Provider Demographics
NPI:1619023256
Name:HILL, RANDALL W (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:W
Last Name:HILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 WINDTREE CT
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-5937
Mailing Address - Country:US
Mailing Address - Phone:360-715-8722
Mailing Address - Fax:360-527-3668
Practice Address - Street 1:1633 BIRCHWOOD AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-9220
Practice Address - Country:US
Practice Address - Phone:360-715-8722
Practice Address - Fax:360-527-3668
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8852523Medicare ID - Type UnspecifiedMCR INDIV #
WAG8852523Medicare PIN