Individual
MICHAEL LOUIS LUCCHESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3219 170TH AVE E, LAKE TAPPS, WA 98391-5530
(253) 363-6207
Mailing address
3219 170TH AVE E, LAKE TAPPS, WA 98391-5530
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9115677
FL
Other
Enumeration date
04/19/2021
Last updated
02/18/2022
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