JESSE LUCKETT, LMT

Contractor

Active Individual
NPI: 1629337555

Practice Address

52 NE FREMONT ST
Portland, OR 97212

Phone: (503) 381-6636

Specialties

Specialty Code Primary License
Contractor 171W00000X Yes 7005 (OR)

Frequently Asked Questions

NPI 1629337555 is the National Provider Identifier for JESSE LUCKETT, LMT, a Contractor provider located in Portland, OR. This NPI was enumerated on May 12, 2012.
JESSE LUCKETT, LMT practices at 52 NE FREMONT ST, Portland, OR 97212.

Quick Facts

NPI
1629337555
Type
Individual
Enumerated
May 12, 2012
Last Updated
May 12, 2012

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