| Doctor Name: | DR. JEFFREY A. LUTY |
| NPI Number: | 1558442335 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD155853 |
| Business Practice Address: | 230 Rowe Rd Wheeler, OR - 971470035 |
| Business Phone Number: | 5033685182 |
| Business Fax Number: | 5033685590 |
| Mailing Address: | 17710 Sw Vincent St, ALOHA |
| State: | OR |
| Postal Code: | 970781782 |
| Phone Number: | 5033144059 |
| Fax Number: | |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 10/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD155853 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |