JACKIE LUCKETT

PORTLAND, OR
NPI1497925390
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
(Licence: OR  172V00000X)
Enumeration Date2008-03-06
Last Update Date2008-03-06
Business Address
JACKIE LUCKETT
1500 NE IRVING ST
PORTLAND, OR 97232-2243
Phone number: 503-258-4222
Mailing Address
JACKIE LUCKETT
629 NW AUTUMNCREEK WAY APT I201
ALOHA, OR 97006-8753
Phone number: 503-515-4826
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