Provider Demographics
NPI:1558385971
Name:LUCE, MARCUS CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:CHRISTOPHER
Last Name:LUCE
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 1:16280 NW BETHANY CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-4887
Mailing Address - Country:US
Mailing Address - Phone:503-713-5330
Mailing Address - Fax:503-334-1256
Practice Address - Street 1:16280 NW BETHANY CT
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4887
Practice Address - Country:US
Practice Address - Phone:503-713-5330
Practice Address - Fax:503-334-1256
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD150397208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500617296Medicaid