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Contact Information

NICOLE R RANDALL
14600 NW CORNELL RD
PORTLAND, OR97229
 Phone: 503-645-3581
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Case Manager/Care Coordinator

171M00000X
 

Technician, Other

247200000X 75 Slide Preparation Facility
Indicates primary specialty

NPI Profile & details for NICOLE R RANDALL · (Female)

NPI Number 1275078024
Status Active
Credentials
Entity Individual
Enumeration date 01/04/2017
Last updated 07/01/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • OR License # A15312
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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