Individual
DR. LUCAS ANTHONY MIRABITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD # P3STARS, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
3710 SW US VETERANS HOSPITAL RD # P3STARS, PORTLAND, OR 97239-2964
(503) 220-8262
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3598
OR
Other
Enumeration date
11/15/2022
Last updated
11/15/2022
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