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Individual

DR. EVAN LOCKARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D

Contact information

Practice address
11010 SE DIVISION ST STE 202, PORTLAND, OR 97266-6400
(503) 335-5975
(503) 335-5974
Mailing address
1630 SE RURAL ST APT 202, PORTLAND, OR 97202-5861
(415) 847-0838

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
3416
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/17/2013
Last updated
07/03/2021
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