Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gregory Randolph, PA-C

Individual provider Physician Assistant · NPI 1780177964

Gregory Randolph, PA-C is a Physician Assistant in Scappoose, Oregon. Qualified in 2019, 7 years ago. Practices with University Professional Services, a 1,704-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
7
Licensed in
OR
In the registry since
2018
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

51377 SW Old Portland Rd Ste C
Scappoose, OR 97056
Phone: (503) 418-4222
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2730 Sw Moody Ave, Portland, OR 97201-5042 — (503) 494-3633

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X
Physician Assistant Taxonomy 363A00000X · Licence PA193627 (OR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1780177964
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 12, 2018
Last updated in NPPESDecember 29, 2020
Certification dateDecember 29, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Scappoose