Organization
MARY W. LU, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LU MD (MEMBER)
(971) 350-8968
Entity
Organization
Contact information
Practice address
1942 NW KEARNEY ST STE 24, PORTLAND, OR 97209-1465
(971) 350-8968
Mailing address
2908 NW THURMAN ST, PORTLAND, OR 97210-1941
(350) 971-8968
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336228386
NPI TYPE 1
—
Enumeration date
11/19/2019
Last updated
11/19/2019
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