Individual
LUCAS DUBEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15660 SW PACIFIC HWY STE A5, TIGARD, OR 97224-3556
(503) 968-6445
(503) 968-8968
Mailing address
6700 WASHINGTON AVE S, EDEN PRAIRIE, MN 55344-3405
(800) 328-8602
(952) 285-3980
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
—
—
237700000X
Hearing Instrument Specialist
Primary
HAS-P-10145077
OR
Other
Enumeration date
08/01/2018
Last updated
04/02/2019
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