Individual
JAY RANDHAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20151 SE HIGHWAY 212, BORING, OR 97089-9220
(503) 658-7005
(503) 658-7081
Mailing address
20151 SE HIGHWAY 212, BORING, OR 97089-9220
(503) 658-7005
(503) 658-7081
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0006510
OR
Other
Enumeration date
12/10/2011
Last updated
12/10/2011
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