Provider Demographics
NPI:1346911237
Name:SLAWTER, RANDI (PA-C)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:SLAWTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RANDI
Other - Middle Name:
Other - Last Name:MIELKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5299
Mailing Address - Street 2:MS: 820-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5238 W LOWELL AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6499
Practice Address - Country:US
Practice Address - Phone:509-530-3100
Practice Address - Fax:509-530-3110
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
WAPA61186369363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant