Individual
JENNIFER ELAINE LOCKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
505 NE 87TH AVE STE 460, VANCOUVER, WA 98664-1965
(360) 514-7771
(360) 514-7769
Mailing address
847 NE 19TH AVE STE 300, PORTLAND, OR 97232-2686
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
632123
CA
363L00000X
Nurse Practitioner
201802036NP-PP
OR
363L00000X
Nurse Practitioner
95003105
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
AP60833511
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2100206
—
WA
05
—
500742544
—
OR
Enumeration date
05/25/2015
Last updated
10/07/2020
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