Individual
JACQUELYN DALE LUTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, AMS
Contact information
Practice address
12910 SE 137TH DR, HAPPY VALLEY, OR 97086-5873
(503) 756-8989
Mailing address
6400 SE LAKE RD STE 175, PORTLAND, OR 97222-2137
(682) 250-7500
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OR
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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