RANDOLPH OTTO MD NPI 1881767606

NPI Information

  • NPI: 1881767606
  • Provider Name: RANDOLPH OTTO, MD
  • Classification: Radiology - 2085P0229X
  • Specialization: Pediatric Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2202 S CEDAR ST STE 200
    TACOMA, WA
    ZIP 98405
  • Phone: (253) 383-1099

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NPI Details

Randolph Otto, MD is a pediatric radiology radiology in Tacoma, WA. The provider is a radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood. Randolph Otto, MD NPI is 1881767606. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2202 S CEDAR ST STE 200
TACOMA, WA
ZIP 98405-318
Phone: (253) 383-1099
Fax: (253) 383-3919

The NPI 1881767606 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085P0229XRadiologyPediatric Radiology00027380WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18125395MEDICAIDWASHINGTON
2E09058MEDICARE UPINWASHINGTON
3OO1055620MEDICARE ID-TYPE UNSPECIFIEDWASHINGTONTACOMA RADIOLOGICAL ASSOC
4AB01917MEDICARE ID-TYPE UNSPECIFIEDWASHINGTONUNION AVENUE OPEN MRI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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