Individual
JULIE KATHLEEN LUCKART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3119 NW IVY CIR, CAMAS, WA 98607-9357
(360) 281-6642
Mailing address
3119 NW IVY CIR, CAMAS, WA 98607-9357
(360) 281-6642
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60954345
WA
Other
Enumeration date
06/01/2019
Last updated
06/01/2019
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