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Individual

MR. REYNALDO LUGO JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 888-1425
(503) 888-1425
Mailing address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 888-1425

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
OR

Other

Enumeration date
10/16/2017
Last updated
10/16/2017
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