Individual
YVETTE MARIE LOCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
1030 NE COUCH ST, PORTLAND, OR 97232-3067
(971) 202-7717
Mailing address
1030 NE COUCH ST, PORTLAND, OR 97232-3067
(971) 202-7717
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21-CRM-492
OR
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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