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 last year |
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 |
Popular Providers
-
Shaffer, Cynthia Fernandez
9309 Apison Pike , Ooltewah TN 37363-4340 -
Lagac, Paul A
774 College Hwy , Southwick MA 01077-9690 -
Maltz, Jonathan
3300 Olney Sandy Spring Rd Ste 330 , Olney MD 20832-3305 -
Chapman, Carolyn Nobuko
10200 Sw Eastridge St Suite 205, Portland OR 97225-5064 -
Levin, Tedd
5919 Se Belmont St , Portland OR 97215-1925 -
Putland, Michael Stuart
14200 W Fillmore St , Goodyear AZ 85338-3005 -
Vanwinkle, David A
6401 Prairie St Suite 1600, Muskegon MI 49444-7840 -
Verzosa, Frances Ventura
10535 Ne Glisan St Ste.100, Portland OR 97220-4077