Provider Demographics
NPI:1548537491
Name:LUKA, LAURA SHANNON (LAC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:SHANNON
Last Name:LUKA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 TRUMBO RD
Mailing Address - Street 2:ATTN: MEDICAL
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6655
Mailing Address - Country:US
Mailing Address - Phone:305-293-2390
Mailing Address - Fax:305-293-3927
Practice Address - Street 1:9375 SW COMMERCE CIR STE A1
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-9630
Practice Address - Country:US
Practice Address - Phone:503-582-9200
Practice Address - Fax:503-582-1487
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
ORAC193227171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other