Individual
ROGELIO LUIS LUGO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
6235 NE 7TH AVE, PORTLAND, OR 97211-3754
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
201710169NP-PP
OR
363LA2100X
Acute Care Nurse Practitioner
AP60799726
WA
Other
Enumeration date
11/30/2017
Last updated
03/07/2018
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