Provider Demographics
NPI:1659770568
Name:LUKE-DORF
Entity Type:Organization
Organization Name:LUKE-DORF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENTIAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RIZZOLO-BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-840-0241
Mailing Address - Street 1:20988 SW SISTER LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6028
Mailing Address - Country:US
Mailing Address - Phone:506-840-9241
Mailing Address - Fax:
Practice Address - Street 1:20988 SW SISTER LN
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-6028
Practice Address - Country:US
Practice Address - Phone:506-840-9241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care