Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD0047434 | WA |
N | 207V00000X | Obstetrician & Gynecologist | J3498 | TX |
N | 207V00000X | Obstetrician & Gynecologist | MD00047434 | WA |
NPI | 1891787933 |
---|---|
Provider Name | Randall D. Howerton |
First Address | Kennewick, WA 99338-2909 |
Second Address | Kennewick, WA 99338-2909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 04/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
132708207 | (05) | TX |
F54662 | (02) | TX |