Provider Demographics
NPI:1245503218
Name:LUKINBEAL, GEOFFREY ALLEN (R PH)
Entity type:Individual
Prefix:MR
First Name:GEOFFREY
Middle Name:ALLEN
Last Name:LUKINBEAL
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51501 COLUMBIA RIVER HWY
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-4539
Mailing Address - Country:US
Mailing Address - Phone:503-543-4533
Mailing Address - Fax:503-543-4527
Practice Address - Street 1:51501 COLUMBIA RIVER HWY
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-4539
Practice Address - Country:US
Practice Address - Phone:503-543-4533
Practice Address - Fax:503-543-4527
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7744183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist