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1740688134
LUCAS JOHN PETERS
PORTLAND, OR
NPI
1740688134
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2014-12-17
Last Update Date
2014-12-17
Business Address
Mr. LUCAS JOHN PETERS
847 NE19TH AVE
PORTLAND, OR 97232
Phone number: 503-238-0769
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Mailing Address
Mr. LUCAS JOHN PETERS
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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