Provider Demographics
NPI:1164406989
Name:LUKACS, JOZSEF (MD)
Entity Type:Individual
Prefix:
First Name:JOZSEF
Middle Name:
Last Name:LUKACS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 NE 47TH AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2238
Mailing Address - Country:US
Mailing Address - Phone:503-731-2900
Mailing Address - Fax:
Practice Address - Street 1:545 NE 47TH AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2238
Practice Address - Country:US
Practice Address - Phone:503-731-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD259882085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213525Medicaid
WA7130669Medicaid
OR840126023OtherREGENCE BS/BC
ORP00232676OtherRR MC
WA7130669Medicaid