Individual
BENJAMIN D RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADCIII
Contact information
Practice address
10600 SE MCLOUGHLIN BLVD STE 207, MILWAUKIE, OR 97222-7428
(503) 901-1836
(503) 654-1852
Mailing address
10600 SE MCLOUGHLIN BLVD STE 207, MILWAUKIE, OR 97222-7428
(503) 901-1836
(503) 654-1852
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
06-07-75U
OR
Other
Enumeration date
04/13/2007
Last updated
01/21/2019
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