Individual
MR. MARC R LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2880
Mailing address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2880
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20A7968
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX79680
—
CA
01
—
020A79680
BS OF CA
CA
Enumeration date
05/30/2006
Last updated
02/04/2022
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