Individual
SEBASTIAN RANDALL RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
(503) 239-8406
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
(503) 239-8406
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
201504791RN
OR
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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