Provider Demographics
NPI:1538720511
Name:BUTTERFIELD, RANDI M (RN)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:M
Last Name:BUTTERFIELD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 S 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-4467
Mailing Address - Country:US
Mailing Address - Phone:509-833-3979
Mailing Address - Fax:509-452-1501
Practice Address - Street 1:616 S 8TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4467
Practice Address - Country:US
Practice Address - Phone:509-833-3979
Practice Address - Fax:509-452-1501
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00092030163W00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse