Individual provider · Type 1 NPI

Ashlie Lynn Randall

Student in an Organized Health Care Education/Training Program · Moscow, ID

NPI number 1619441540 Active

Practice location

875 Perimeter Dr
Moscow, ID 83844-9803

Call (208) 885-6111 Map

Mailing address

PO Box 1857
Waldport, OR 97394-1857

Other practice locations

  • 640 SE Ball Blvd, Waldport, OR 97394 · (208) 318-8397

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1619441540

Ashlie Lynn Randall's National Provider Identifier is 1619441540, issued on Jan 14, 2019. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Moscow, ID. The record was last updated on Jan 14, 2019.