Pearson, Randolph C
Pearson, Randolph C is an sole proprietor health care provider with primary practice located at 121 W Poplar St Ste C, Walla Walla WA 99362-2871. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Pearson, Randolph C can be contacted via phone (509) 525-2850.Contact Information
Primary practice address
121 W Poplar St Ste C
Walla Walla WA 99362-2871
Phone: (509) 525-2850
Fax: (509) 529-6545
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 4967 | Washington |
Profile Details
| NPI number | 1336122852 |
|---|---|
| LBN Legal business name | Pearson, Randolph C |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 29th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336122852 | NPPES |
| Washington | MEDICAID | 5512702 |
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