Provider Demographics
NPI:1962049312
Name:LUCASNAV, LLC
Entity type:Organization
Organization Name:LUCASNAV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GENGHIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:206-372-0959
Mailing Address - Street 1:1117 23RD AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-3026
Mailing Address - Country:US
Mailing Address - Phone:206-372-0959
Mailing Address - Fax:206-501-4751
Practice Address - Street 1:2717 DEXTER AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1999
Practice Address - Country:US
Practice Address - Phone:206-372-0959
Practice Address - Fax:206-501-4751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty