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1194195099
SEBASTIAN RANDALL RANDALL
PORTLAND, OR
NPI
1194195099
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: OR 201504791RN)
Enumeration Date
2015-10-05
Last Update Date
2015-10-05
Business Address
-- SEBASTIAN RANDALL RANDALL
1027 E BURNSIDE ST
PORTLAND, OR 97214-1328
Phone number: 503-239-8400
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Mailing Address
-- SEBASTIAN RANDALL RANDALL
1027 E BURNSIDE ST
PORTLAND, OR 97214-1328
Phone number: 503-239-8400
Copy
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