Individual
LUCAS JOHN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4259 23RD AVE W, SUITE 200, SEATTLE, WA 98199-1534
(206) 612-7869
Mailing address
2850 SE POWELL VALLEY RD, GRESHAM, OR 97080-1494
(503) 666-5050
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 60516081
WA
363A00000X
Physician Assistant
PA169881
OR
Other
Enumeration date
05/04/2015
Last updated
04/29/2020
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