Healthcare Provider Details

I. General information

NPI: 1699690982
Provider Name (Legal Business Name): LUKAS LUBCHENCO QMHP-I
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 TUCKER RD
HOOD RIVER OR
97031-9591
US

IV. Provider business mailing address

965 TUCKER RD
HOOD RIVER OR
97031-9591
US

V. Phone/Fax

Practice location:
  • Phone: 541-386-6665
  • Fax: 541-386-3071
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: