Individual provider · Type 1 NPI

Gregory Randolph, PA-C

Medical Physician Assistant · Scappoose, OR

NPI number 1780177964 Active

Practice location

51377 SW Old Portland Rd. Suite C
Scappoose, OR 97056

Call (503) 418-4222 Map

Other practice locations

  • 2730 SW Moody Ave, Portland, OR 97201-5042 · (503) 494-3633

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA193627 (OR)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1780177964

Gregory Randolph, PA-C's National Provider Identifier is 1780177964, issued on Jun 12, 2018. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Scappoose, OR. The record was last updated on Dec 29, 2020.