Individual
DR. LORI FRANCINE GLUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15640 NW LAIDLAW RD, SUITE 102, PORTLAND, OR 97229-3828
(503) 764-0100
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A83810
CA
207Q00000X
Family Medicine Physician
Primary
MD21336
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138087
—
OR
01
—
P00873826
RR MEDICARE
OR
Enumeration date
02/02/2006
Last updated
10/14/2020
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