Individual
MRS. KIM E. LUCEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1020 SW TAYLOR ST STE 700, 1125, PORTLAND, OR 97205-2512
(971) 225-0105
Mailing address
1020 SW TAYLOR ST STE 700, 1125, PORTLAND, OR 97205-2512
(971) 225-0105
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3676
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500653429
—
OR
Enumeration date
01/23/2013
Last updated
07/27/2016
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