GREGORY RANDOLPH, PA-C
Physician Assistant - Medical
Active
Individual
NPI: 1780177964
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant | 363A00000X | No | PA193627 (OR) |
| Student in an Organized Health Care Education/Training Program | 390200000X | No | - |
| Physician Assistant - Medical | 363AM0700X | Yes | - |
Frequently Asked Questions
NPI 1780177964 is the National Provider Identifier for GREGORY RANDOLPH, PA-C, a Physician Assistant - Medical provider located in Scappoose, OR. This NPI was enumerated on June 12, 2018.
GREGORY RANDOLPH, PA-C practices at 51377 SW OLD PORTLAND RD. SUITE C, Scappoose, OR 97056.
Quick Facts
- NPI
- 1780177964
- Type
- Individual
- Enumerated
- Jun 12, 2018
- Last Updated
- Dec 29, 2020
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