Individual
PETER LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3036 NE MLK BLVD, PORTLAND, OR 97212-3053
(503) 283-3763
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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