Individual
KELSEY LOCKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, RT(R)
Contact information
Practice address
2925 RYAN DR SE, SALEM, OR 97301-9687
(503) 399-1262
Mailing address
2925 RYAN DR SE, SALEM, OR 97301-9687
(503) 399-1262
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61454774
WA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA201560
OREGON STATE LICENSE
OR
Enumeration date
02/26/2020
Last updated
06/28/2024
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