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NPI Code Detail

MEDICARE: LUCAS COLE SHORT

MEDICARE: LUCAS COLE SHORT
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
1390200000XStudent in an Organized Health Care Education/Training Program
2208M00000XHospitalist PhysicianDO223828OR
3207Q00000XFamily Medicine PhysicianDO223828OR

General Provider Information

NPI Number : 1326667510
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCAS COLE SHORT
Provider Business Mailing Address
First Line : 200 MULLINS DR
Second Line :
City : LEBANON
State : OR
Zip : 97355-3983
Country : US
Telephone Number : 541-259-0235
Fax Number :
Provider Business Practice Location Address
First Line : 200 MULLINS DR
Second Line :
City : LEBANON
State : OR
Zip : 97355-3983
Country : US
Telephone Number : 541-259-0235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2020
Last Update Date : 05/18/2026

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Directions to “ LUCAS COLE SHORT ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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