Individual
SUCELY GIOVANNA MARIE LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12360 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9320
(503) 303-4000
Mailing address
16449 PLEASANT VALLEY DR NE, SILVERTON, OR 97381-9752
(503) 989-9143
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
OR
Other
Enumeration date
12/11/2023
Last updated
04/25/2024
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