DR. GRETCHEN RANDOLPH (NPI# 1184876898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184876898 |
| Entity Type | Individual |
| Full Name | DR. GRETCHEN RANDOLPH |
| Credential | PH.D, PMHNP |
| Practice Address |
13635 Sw 115th Ave Tigard OR 97223-2862 |
| Practice Telephone | 5039681155 |
| Mailing Telephone | 5039681155 |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
S80045119NG | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
13635 SW 115TH AVE |
| City | TIGARD |
| State | OR |
| Zip Code | 97223-2862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366071607 | Med Rx Partners, P.C. | Nurse Practitioner | 12115 Sw 70th Ave Ste 202, Tigard, OR 97223-9648 | 2020-04-08 |
| 1417583170 | Brittany Joy Monson | Nurse Practitioner | 12115 Sw 70th Ave, Tigard, OR 97223-9647 | 2020-03-13 |
| 1942525761 | Anthony Pabst | Nurse Practitioner | 7105 Sw Varns St Ste 270, Tigard, OR 97223-8173 | 2010-04-05 |
| 1760651442 | Timothy Allen Perez | Nurse Practitioner | 7105 Sw Varns St, Suite 270, Tigard, OR 97223-8173 | 2008-02-26 |
| 1841209061 | Julie Hogen Pmhnp LLC | Nurse Practitioner | 6950 Sw Hampton Street, #109, Tigard, OR 97223-8330 | 2006-08-05 |
| 1750900924 | Tms Nw Pllc | Nurse Practitioner | 12115 Sw 70th Ave Ste 202, Tigard, OR 97223-9648 | 2020-04-08 |
| 1679041743 | Bethany Marie Carter | Nurse Practitioner | 7105 Sw Varns St Ste 270, Tigard, OR 97223-8173 | 2018-11-07 |
| 1679933113 | Simona Borza Pmhnp, LLC | Nurse Practitioner | 9600 Sw Oak St, Suite 325, Tigard, OR 97223-6583 | 2016-02-25 |
| 1316311665 | Denyse Collins | Nurse Practitioner | 11900 Sw Greenburg Rd, Tigard, OR 97223-6453 | 2015-11-24 |
| 1669784138 | Elizabeth Brudney | Nurse Practitioner | 7455 Sw Beveland Rd, Tigard, OR 97223-8610 | 2010-07-12 |
| Find all providers in TIGARD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.