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Individual

JONATHAN SCOTT LUTGENS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-3105
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-3105

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/05/2022
Last updated
08/08/2023
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