Individual
NAOMI LOUCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16420 SE DIVISION ST, PORTLAND, OR 97236-1987
(503) 762-3130
Mailing address
1928 NW 26TH AVE, CAMAS, WA 98607-9034
(360) 901-2730
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201130601LPN
OR
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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