| Doctor Name: | RANDALL BRADFORD CHOKA |
| NPI Number: | 1417206442 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | AP60291455 |
| Business Practice Address: | 229 S 7th St St Maries, ID - 838611803 |
| Business Phone Number: | 2082455551 |
| Business Fax Number: | 2082455246 |
| Mailing Address: | 229 S 7th St, ST MARIES |
| State: | ID |
| Postal Code: | 838611803 |
| Phone Number: | 2082455551 |
| Fax Number: | 2082455246 |
| NPI Enumeration Date: | 09/06/2012 |
| NPI Last Update Date: | 09/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP60291455 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |