Randolph, Kamala Joy

Randolph, Kamala Joy is an individual health care provider with primary practice located at 1427 Nw Flanders St Ste A , Portland OR 97209-2646. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Randolph, Kamala Joy can be contacted via phone (503) 972-0235.

Contact Information

Primary practice address
1427 Nw Flanders St Ste A Portland OR 97209-2646
Phone: (503) 972-0235
Fax: (971) 216-4964
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD00048113 Washington
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD00048113 Washington
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD28882 Oregon

Profile Details

NPI number 1801002548
LBN Legal business name Randolph, Kamala Joy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2007
Last updated Mar 17th, 2018 - about 8 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 1801002548 NPPES
Washington MEDICAID 8482374
Washington MEDICAID 500648424

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