Luckett, Jackie

Luckett, Jackie is an sole proprietor health care provider with primary practice located at 1500 Ne Irving St , Portland OR 97232-2243. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Luckett, Jackie can be contacted via phone (503) 258-4222.

Contact Information

Primary practice address
1500 Ne Irving St Portland OR 97232-2243
Phone: (503) 258-4222
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X 172V00000X Oregon

Profile Details

NPI number 1497925390
LBN Legal business name Luckett, Jackie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 6th, 2008
Last updated Mar 6th, 2008 - about 17 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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