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Organization

LUCENT PSYCHIATRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN WILSON MD (COO)
(503) 213-6167
Entity
Organization

Contact information

Practice address
311 B AVE STE R, LAKE OSWEGO, OR 97034-3071
(503) 213-6167
Mailing address
311 B AVE STE R, LAKE OSWEGO, OR 97034-3071

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
10/11/2023
Last updated
10/11/2023
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