Provider Demographics
NPI:1407178031
Name:LUCAS, MATHEW RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:RICHARD
Last Name:LUCAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 WILLIAMS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-3207
Mailing Address - Country:US
Mailing Address - Phone:509-946-0631
Mailing Address - Fax:
Practice Address - Street 1:604 WILLIAMS BLVD STE A
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3207
Practice Address - Country:US
Practice Address - Phone:509-946-0631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60135666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor