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NPI Code Detail

MEDICARE: SANDRA RENE LUCAS MA

MEDICARE:   SANDRA RENE LUCAS  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1154455368
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA RENE LUCAS MA
Provider Business Mailing Address
First Line : 851 NE BAKER ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-4991
Country : US
Telephone Number : 503-435-4840
Fax Number : 503-200-1416
Provider Business Practice Location Address
First Line : 851 NE BAKER ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-4991
Country : US
Telephone Number : 503-435-4840
Fax Number : 503-200-1416
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/14/2025

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Directions to “ SANDRA RENE LUCAS MA” Practice Location

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