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Individual

RANDY LIM JAILANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
8100 SW NYBERG ST STE 200, TUALATIN, OR 97062-8437
(503) 570-3365
Mailing address
8100 SW NYBERG ST STE 200, TUALATIN, OR 97062-8437
(503) 570-3365

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2155382
TX
225200000X
Physical Therapy Assistant
Primary
CP004282A
OR

Other

Enumeration date
04/29/2022
Last updated
05/02/2022
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