Individual
GREGORY RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
51377 SW OLD PORTLAND RD. SUITE C, SCAPPOOSE, OR 97056
(503) 418-4222
Mailing address
51377 SW OLD PORTLAND RD. SUITE C, SCAPPOOSE, OR 97056
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA193627
OR
363AM0700X
Medical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2018
Last updated
12/29/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us