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Organization
NORTHWEST PEDIATRIC KIDNEY SPECIALISTS LLC
Active
Organization
NORTHWEST PEDIATRIC KIDNEY SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL JENKINS MD (DOCTOR)
(503) 297-3178
Entity
Organization
Contact information
Practice address
1935 NW NORFOLK CT, PORTLAND, OR 97229-8448
(503) 297-3178
Mailing address
1935 NW NORFOLK CT, PORTLAND, OR 97229-8448
(503) 297-3178
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
MD12771
OR
Other
Enumeration date
05/31/2007
Last updated
05/18/2012
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