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General NPI Number Information
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NPI Number | 1376608356
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Entity Type | Individual
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Provider Name | RANDALL CHANEY COLEMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 21810 WILLAMETTE DR
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City | WEST LINN
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State | OR
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Zip | 97068-3256
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Country | US
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Telephone | 503-656-6603
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Fax | 503-557-8012
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Provider Business Mailing Address
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Address Line | 2337 TAYLOR DR
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City | WEST LINN
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State | OR
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Zip | 97068-4163
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Country | US
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Telephone | 503-657-9811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 11722
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License Number State | OR
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