Lucille Levinia Becker, DT, DO
Individual provider Active NPI Denturist · Sutherlin, OR
NPI 1770078685 · NPPES record last updated Jul 21, 2020
Key facts
- NPI
- 1770078685
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Denturist 122400000X
- License
- DT-DO-10193177 (OR)
- Practice address
- 155 N Umpqua St
Sutherlin, OR 97479-9567 - Phone
- (541) 837-1717
- NPI assigned
- Jun 25, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT-DO-10193177 | OR | MD | Denturist |
| DT-TMP-10192123 | OR | MD | Denturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Denturist | 122400000X | DT-TMP-10192123 | OR | |
| Denturist | 122400000X | DT-DO-10193177 | OR | Yes |
Addresses
Primary practice location
155 N Umpqua St
Sutherlin, OR 97479-9567
Mailing address
PO Box 8075
Coburg, OR 97408-1301
Other practice location 1
2365 NW Stewart Pkwy
Roseburg, OR 97471-5653
Phone (855) 433-6825
Other practice location 2
2530 Game Farm Road
Springfield, OR 97477
Phone (855) 433-6825
Other providers in Sutherlin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.