Provider Demographics
NPI:1942768700
Name:ULLAURI, LUCIA
Entity Type:Individual
Prefix:MS
First Name:LUCIA
Middle Name:
Last Name:ULLAURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 SW FIR LOOP
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8084
Mailing Address - Country:US
Mailing Address - Phone:971-283-1120
Mailing Address - Fax:
Practice Address - Street 1:7110 SW FIR LOOP
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8084
Practice Address - Country:US
Practice Address - Phone:971-283-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0441172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker