Healthcare Provider Details

I. General information

NPI: 1548019649
Provider Name (Legal Business Name): CARRIE ROCHELLE LUKE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 NW BAILEY AVE
PENDLETON OR
97801-1531
US

IV. Provider business mailing address

802 NW BAILEY AVE
PENDLETON OR
97801-1531
US

V. Phone/Fax

Practice location:
  • Phone: 541-969-4537
  • Fax:
Mailing address:
  • Phone: 541-969-4537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL11554
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: