Individual
MS. LAURA LUCZKIW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3680 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 754-1150
Mailing address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1150
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
10173907
OR
133V00000X
Registered Dietitian
Primary
10202533
OR
Other
Enumeration date
12/22/2015
Last updated
12/03/2019
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