# NORTHWEST PEDIATRIC KIDNEY SPECIALISTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801098108
- **Authorized official:** DR. RANDALL JENKINS MD (DOCTOR)
- **Authorized official phone:** (503) 297-3178

## Contact information

- **Practice address:** 1935 NW NORFOLK CT, PORTLAND, OR 97229-8448
- **Practice address phone:** (503) 297-3178
- **Mailing address:** 1935 NW NORFOLK CT, PORTLAND, OR 97229-8448
- **Mailing address phone:** (503) 297-3178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0210X | Pediatric Nephrology Physician | MD12771 | OR | Yes |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 05/18/2012