Individual
SAMANTHA RAE LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 NW MYHRE RD, SILVERDALE, WA 98383-7663
(360) 744-8928
Mailing address
1166 CHIMACUM RD, PORT HADLOCK, WA 98339-9715
(360) 301-2044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61417194
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/29/2021
Last updated
03/22/2023
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