Individual
MARISSA BONUS LUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
808 SW 15TH AVE, PORTLAND, OR 97205-1907
(503) 274-4774
Mailing address
808 SW 15TH AVE, PORTLAND, OR 97205-1907
(503) 274-4994
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD209009
OR
207VE0102X
Reproductive Endocrinology Physician
Primary
MD209009
OR
Other
Enumeration date
03/19/2018
Last updated
05/13/2025
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