Healthcare Provider Details

I. General information

NPI: 1396665352
Provider Name (Legal Business Name): LUCAS K. STEFFL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 NW 22ND AVE STE 640
PORTLAND OR
97210-2993
US

IV. Provider business mailing address

PO BOX 3068
PORTLAND OR
97208
US

V. Phone/Fax

Practice location:
  • Phone: 503-229-7976
  • Fax: 503-274-4867
Mailing address:
  • Phone: 503-229-7976
  • Fax: 503-274-4867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA232396
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: