Individual
JOHN R LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 E 3RD ST STE 101, THE DALLES, OR 97058-2563
(541) 298-2101
(541) 298-7996
Mailing address
702 SUNSET DR, ONTARIO, OR 97914-3121
(541) 889-9167
(541) 889-7873
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/07/2019
Last updated
11/21/2022
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