Individual
LUCIANO NICOLAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 NE 19TH AVE, PORTLAND, OR 97232-4801
(971) 405-5307
Mailing address
411 NE 19TH AVE, PORTLAND, OR 97232-4801
(971) 405-5307
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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