Individual
MR. TIMOTHY D LOCKNANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12911 120TH AVE NE, SUITE H-210, KIRKLAND, WA 98034-3027
(425) 823-4000
(425) 821-3550
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD00036179
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1856LO
REGENCE
WA
01
—
204713
LABOR AND INDUSTRIES
WA
01
—
5237760
AETNA
WA
01
—
56-2521538
TAX ID
WA
Enumeration date
01/24/2007
Last updated
08/13/2016
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