Lookup NPI Numbers from the NPI Registry
NPI Profile for GREGORY RANDOLPH in SCAPPOOSE, OR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant | |
Physician Assistant |
363A00000X | 97 | Physician Assistant | |
Student in an Organized Health Care Education/Training Program |
390200000X |
| NPI Number | 1780177964 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 06/12/2018 | |
| Last updated | 12/29/2020 - About 5 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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GREGORY RANDOLPH
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GREGORY RANDOLPH, PA-C