Individual
LUCINDA KAE MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
(615) 861-6000
Mailing address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
202113403LPN
OR
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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