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1225252612
BENJAMIN D RANDOLPH
MILWAUKIE, OR
NPI
1225252612
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 06-07-75U)
Enumeration Date
2007-04-13
Last Update Date
2019-01-21
Business Address
BENJAMIN D RANDOLPH CADCIII
10600 SE MCLOUGHLIN BLVD STE 207
MILWAUKIE, OR 97222-7428
Phone number: 503-901-1836
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Mailing Address
BENJAMIN D RANDOLPH CADCIII
10600 SE MCLOUGHLIN BLVD STE 207
MILWAUKIE, OR 97222-7428
Phone number: 503-901-1836
Copy
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