Amy Nicole Lacoste, DMD is a
Student In An Organized Health Care Education/training Program based in Portland, Oregon. Amy Nicole Lacoste is licensed to practice in * (Not Available) (license number ) and her current practice location is
2730 S Moody Ave, Portland, Oregon. She can be reached at her office (for appointments etc.) via phone at
(503) 494-8867.
NPI number for Amy Nicole Lacoste is 1518699263 and her current mailing address is 4815 Sw Lombard Ave Apt 427, Beaverton, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1518699263.
Healthcare Provider's Profile
| Full Name | Amy Nicole Lacoste |
|---|
| Gender | Female |
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| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 2730 S Moody Ave, Portland, Oregon |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1518699263
- Provider Enumeration Date: 06/29/2022
- Last Update Date: 03/08/2024
Medical Identifiers
Medical identifiers for Amy Nicole Lacoste such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1518699263 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | D11898 (Oregon) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy Nicole Lacoste is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Amy Nicole Lacoste, DMD
4815 Sw Lombard Ave Apt 427,
Beaverton, OR 97005-3061
Ph: (916) 532-2690 | Amy Nicole Lacoste, DMD
2730 S Moody Ave,
Portland, OR 97201-5042
Ph: (503) 494-8867 |
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