Individual
MATTHEW J LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2738 NE BROADWAY ST, PORTLAND, OR 97232-1723
(503) 383-1107
Mailing address
1631 NE BROADWAY ST # 141, PORTLAND, OR 97232-1425
(646) 243-1379
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11778
OR
Other
Enumeration date
09/17/2021
Last updated
03/27/2025
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