Provider Demographics
NPI:1851826598
Name:BUTLER, LUCAS CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:CHRISTOPHER
Last Name:BUTLER
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 1:1516 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3224
Mailing Address - Country:US
Mailing Address - Phone:203-215-1111
Mailing Address - Fax:
Practice Address - Street 1:11567 CANTERWOOD BLVD FL 1
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5812
Practice Address - Country:US
Practice Address - Phone:253-530-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD60981075207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program