Samantha Joe Luchtenburg
Counselor, Mental Health in Portland, OR. Individual provider (NPI-1).
NPI number1164080115
StatusActive
Last updated in NPPESJun 4, 2019
Details
- NPI
- 1164080115
- Entity type
- Individual (NPI-1)
- Name
- Samantha Joe Luchtenburg
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 4, 2019
- Last updated
- Jun 4, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
9320 Sw Barbur Blvd Ste 200Portland, OR 97219-5499
Phone 503-222-9661
Mailing address
9320 Sw Barbur Blvd Ste 200Portland, OR 97219-5499
Phone 503-222-9661
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