Provider Demographics
NPI:1306853668
Name:LUKENS, DAVID LEE (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:LUKENS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1802 YAKIMA AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5305
Mailing Address - Country:US
Mailing Address - Phone:253-572-7101
Mailing Address - Fax:253-572-9461
Practice Address - Street 1:1802 YAKIMA AVE STE 304
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5305
Practice Address - Country:US
Practice Address - Phone:253-572-7101
Practice Address - Fax:253-572-9461
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAOP0000600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE31793Medicare UPIN