Individual
AIYANA LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4531 SE BELMONT ST STE 310B, PORTLAND, OR 97215
(971) 361-6747
Mailing address
3335 SE 69TH AVE, PORTLAND, OR 97206-2613
(503) 810-1170
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7814
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500731868
—
OR
Enumeration date
05/05/2016
Last updated
03/16/2019
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