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Search › Oregon › 164W00000X

Connie Randolph, LPN

NPI 1184976318 · on the registry since 2012 · sole proprietor

Practice

Address
4531 Se Belmont St Ste 100
Portland, OR 97215
Phone
(503) 215-9800
Fax
(503) 215-9801
Organisation at this address
Awake Together
Wild Hearts Pdx
Jon Fox, Ms, Lpc
Ivana Maclay Llc
Lightshinepdx Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
184

Registry record

Primary taxonomy
164W00000X
164W00000X
Licence states on file
OR
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2012-10-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon