Organization
ZOCALO WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANNA NICHOLE LOCKE L.AC (OWNER)
(503) 724-4321
Entity
Organization
Contact information
Practice address
2100 NE BROADWAY ST STE 225, PORTLAND, OR 97232-1544
(503) 724-4321
(971) 255-1754
Mailing address
2100 NE BROADWAY ST STE 225, PORTLAND, OR 97232-1544
(503) 724-4321
(971) 255-1754
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
AC156050
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500639308
—
OR
Enumeration date
11/24/2015
Last updated
11/24/2015
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