Organization
LOCKNANE ATHLETIC MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY D LOCKNANE M.D. (OWNER/DOCTOR)
(425) 368-4242
Entity
Organization
Contact information
Practice address
18518 BOTHELL WAY NE STE C, BOTHELL, WA 98011-1927
(425) 368-4242
(425) 368-4243
Mailing address
18518 BOTHELL WAY NE STE C, BOTHELL, WA 98011-1927
(425) 368-4242
(425) 368-4243
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MD00036179
WA
261QP2300X
Primary Care Clinic/Center
MD00036179
WA
Other
Enumeration date
09/28/2007
Last updated
09/28/2007
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