Active NPI
Lucas Elliot Spencer, CHW
- Community Health Worker
- Portland, OR
National Provider Identifier
1174317622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 110875
- Practice address
- 300 N Graham St Ste 200
Portland, OR 97227-1676 - Phone
- (503) 413-2908
- Fax
- (503) 413-1895
- NPI assigned
- Apr 8, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 110875 | OR | Primary |
Addresses
Primary practice location
300 N Graham St Ste 200
Portland, OR 97227-1676
Mailing address
300 N Graham St Ste 200
Portland, OR 97227-1676
Phone (503) 413-2908
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110875 | OR | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744070400000",
"number": "1174317622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 N GRAHAM ST STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271676",
"telephone_number": "503-413-2908",
"fax_number": "503-413-1895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N GRAHAM ST STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271676",
"telephone_number": "503-413-2908",
"fax_number": "503-413-1895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "LUCAS",
"middle_name": "ELLIOT",
"name_prefix": "Mr.",
"credential": "CHW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-08",
"last_updated": "2025-04-08",
"certification_date": "2025-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "110875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.