MEDICARE: DR. LUKAS STREICH MD

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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	125.072348	IL
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD210940	OR

General Provider Information

NPI Number	:	1538552203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUKAS STREICH MD

Provider Business Mailing Address
First Line	:	1348 NE CUSHING DR
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-3876
Country	:	US
Telephone Number	:	541-382-7696
Fax Number	:	541-389-5723

Provider Business Practice Location Address
First Line	:	3181 SW SAM JACKSON PARK RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3011
Country	:	US
Telephone Number	:	503-494-8276
Fax Number	:	503-494-2025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	03/03/2026

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Directions to “ DR. LUKAS STREICH MD” Practice Location

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