Glick, Lucille Rose

Glick, Lucille Rose is an individual health care provider with primary practice located at 3727 Ne Martin Luther King Jr Blvd , Portland OR 97212-1112. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Glick, Lucille Rose can be contacted via phone (503) 788-7273.

Contact Information

Primary practice address
3727 Ne Martin Luther King Jr Blvd Portland OR 97212-1112
Phone: (503) 788-7273
Fax: (503) 788-7285
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 201808695NP-PP Oregon

Profile Details

NPI number 1841775434
LBN Legal business name Glick, Lucille Rose
Credentials Master of Science in Nursing (MSN)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2018
Last updated May 11th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841775434 NPPES
Oregon MEDICAID 500756023

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