Individual
DOUGLAS MICHAEL LACKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 N INTERSTATE AVE, INTERSTATE MEDICAL OFFICE CENTRAL, PORTLAND, OR 97227-1106
(503) 285-9321
Mailing address
KAISER PERMANENTE INTERSTATE MEDICAL OFFICE CENTRAL, 3600 N. INTERSTATE AVE, PORTLAND, OR 97227-1116
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
MD18334
OR
207RX0202X
Medical Oncology Physician
WA MD00032902
WA
Other
Enumeration date
09/06/2006
Last updated
06/18/2025
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