Jura, Randell Peter
Jura, Randell Peter is an sole proprietor health care provider with primary practice located at 10915 Se Stark St , Portland OR 97216-3348. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as his primary health care specialty. Jura, Randell Peter can be contacted via phone (503) 261-1120.Contact Information
Primary practice address
10915 Se Stark St
Portland OR 97216-3348
Phone: (503) 261-1120
Fax: (503) 261-8936
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | 12431 | Oregon |
Profile Details
NPI number | 1104272921 |
---|---|
LBN Legal business name | Jura, Randell Peter |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 11th, 2016 |
Last updated | Jul 21st, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1104272921 | NPPES |
Oregon | MEDICAID | 26053-9 | |
Oregon | Other | 0000BHPBD |
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