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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GREGORY RANDOLPH, PA-C

Active Sole Proprietor

GREGORY RANDOLPH, PA-C is a Medical Physician Assistant healthcare provider located in SCAPPOOSE, Oregon. NPI 1780177964 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · SCAPPOOSE, OR

Registration Details

NPI Number
1780177964
Provider Type
Individual
Gender
Male
NPI Issued
Jun 12, 2018 (8.1531942380891 yrs)
Last Updated
Dec 29, 2020
License
PA193627 (OR)
Sole Proprietor
Yes

Practice Information

Address
51377 SW OLD PORTLAND RD. SUITE C
SCAPPOOSE, OR, 97056
Browse OR providers · Browse ZIP 97056
Phone
5034184222
Primary Specialty
Medical Physician Assistant
363AM0700X
Additional Specialty
Medical Physician Assistant

Other Medical Physician Assistant Providers in SCAPPOOSE, OR

Name Credential NPI
MS. MARY C REGAN PA-C 1740276344
MICHAEL EARL YETTER PA-C 1538196621
IAN RICHARD PENNER PA-C 1457680613
MS. AUBREY BRIDGES 1700103975
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.