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General NPI Number Information
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NPI Number | 1548180904
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Entity Type | Individual
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Provider Name | LUCJA HANCOCH
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Gender | Female
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 07/16/2026
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Provider Practice Location Address
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Address Line | 388 STATE ST
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City | SALEM
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State | OR
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Zip | 97301-3866
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Country | US
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Telephone | 503-908-6050
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Fax |
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Provider Business Mailing Address
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Address Line | 3406 SE 118TH AVE
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City | PORTLAND
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State | OR
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Zip | 97266-1612
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Country | US
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Telephone | 385-770-6291
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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