Individual
MR. RICKY SHAUN DELUCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1304 N EMERSON ST APT 5, PORTLAND, OR 97217-3770
(503) 313-1299
Mailing address
1304 N EMERSON ST APT 5, PORTLAND, OR 97217-3770
(503) 313-1299
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
372600000X
OR
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/16/2007
Last updated
02/07/2009
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