Lee, Randall G.

Lee, Randall G. is an individual health care provider with primary practice located at 1015 Nw 22Nd Ave , Portland OR 97210-3025. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as his primary health care specialty. Lee, Randall G. can be contacted via phone (503) 413-7494.

Contact Information

Primary practice address
1015 Nw 22Nd Ave Portland OR 97210-3025
Phone: (503) 413-7494
Fax: (503) 413-6267
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X MD15204 Oregon

Profile Details

NPI number 1184761058
LBN Legal business name Lee, Randall G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2007
Last updated May 13th, 2009 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184761058 NPPES
Oregon MEDICAID 149690
Oregon MEDICAID 1032531

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