Provider Demographics
NPI:1154455368
Name:LUCAS, SANDRA RENE (MA)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:RENE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 NE BAKER ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-4991
Mailing Address - Country:US
Mailing Address - Phone:503-435-4840
Mailing Address - Fax:503-200-1416
Practice Address - Street 1:851 NE BAKER ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4991
Practice Address - Country:US
Practice Address - Phone:503-435-4840
Practice Address - Fax:503-200-1416
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist