Individual
DR. JILL JACQUELINE LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4909 25TH AVE NE, SEATTLE, WA 98105-4107
(206) 987-8080
Mailing address
5526 34TH AVE NE, SEATTLE, WA 98105-2305
(818) 384-3554
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
60919089
WA
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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