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

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.

See every abbreviation used in this directory →

Practice location Address checks out

51377 SW Old Portland Rd Ste C
Scappoose, OR 97056
Phone: (503) 418-4222
Show map & directions

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
Mailing address51377 Sw Old Portland Rd. Suite C, Scappoose, OR 97056

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