Most Relevant Information
Provider Data
| NPI Number: | 1003271727 |
| Provider Name: | LAURA LUCZKIW |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 10173907 |
Most Important Dates
| Enumeration Date: | 12/22/2015 |
| Last Updated: | 12/03/2019 |
Provider Practice Location
3680 NW SAMARITAN DR
CORVALLIS
OR
973303737
Practice Location Phone/Fax
| Phone: | 5417541150 |
| Fax: |
Provider Mailing Location
444 NW ELKS DR
CORVALLIS
OR
973303745
Provider Mailing Phone/Fax
| Phone: | 5417541150 |
| Fax: |