BENJAMIN D RANDOLPH

MILWAUKIE, OR
NPI1225252612
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  06-07-75U)
Enumeration Date2007-04-13
Last Update Date2019-01-21
Business Address
BENJAMIN D RANDOLPH CADCIII
10600 SE MCLOUGHLIN BLVD STE 207
MILWAUKIE, OR 97222-7428
Phone number: 503-901-1836
Mailing Address
BENJAMIN D RANDOLPH CADCIII
10600 SE MCLOUGHLIN BLVD STE 207
MILWAUKIE, OR 97222-7428
Phone number: 503-901-1836