Individual
MR. LUKE GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
2428 W REYNOLDS AVE, CENTRALIA, WA 98531-4554
(360) 330-9044
(360) 736-3139
Mailing address
2428 W REYNOLDS AVE, CENTRALIA, WA 98531-4554
(360) 330-9044
(360) 736-3139
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
716210
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
22194
CA
Other
Enumeration date
01/06/2011
Last updated
12/08/2016
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