Gore, Randall D

Gore, Randall D is an sole proprietor health care provider with primary practice located at 9290 Se Sunnybrook Blvd Suite 120, Clackamas OR 97015-6899. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Gore, Randall D can be contacted via phone (503) 215-2110.

Contact Information

Primary practice address
9290 Se Sunnybrook Blvd Suite 120 Clackamas OR 97015-6899
Phone: (503) 215-2110
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD08210 Oregon

Profile Details

NPI number 1639163447
LBN Legal business name Gore, Randall D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 7th, 2005
Last updated Feb 12th, 2013 - about 13 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 1639163447 NPPES
Oregon Other 111913558 PALMETTO GBA
Oregon MEDICAID 231167 PALMETTO GBA

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