JESSE LUCKETT, LMT
Contractor
Active
Individual
NPI: 1629337555
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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