Provider Demographics
NPI:1154399327
Name:JAMES, RANDELL S (CRNA)
Entity type:Individual
Prefix:
First Name:RANDELL
Middle Name:S
Last Name:JAMES
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W 5TH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2715
Mailing Address - Country:US
Mailing Address - Phone:509-344-2663
Mailing Address - Fax:509-624-9179
Practice Address - Street 1:601 W 5TH AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2756
Practice Address - Country:US
Practice Address - Phone:509-344-2663
Practice Address - Fax:509-624-9179
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA037924367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0815613OtherDEPT OF LABOR & INDUSTRIE
WA8938962OtherCRIME VICTIMS
WA8238JAOtherASURIS NW HEALTH
WA9604554Medicaid
MT4303907Medicaid
ID00010147511OtherREGENCE BS OF IDAHO
WA28404OtherGROUP HEALTH NW
WAP00159866OtherRR MEDICARE
WAP00159866OtherRR MEDICARE
WAG8803623Medicare ID - Type Unspecified