Individual
JEFFREY LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN/CRNA
Contact information
Practice address
1330 COMMERCIAL ST SE, SALEM, OR 97302-4206
(503) 763-1973
(503) 763-8886
Mailing address
5120 ELK RUN DR SW, ALBANY, OR 97321-3731
(541) 924-2815
(541) 924-2815
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
081046589
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048475
AANA
OR
01
—
081046589
RN/CRNA
OR
05
—
262825
—
OR
01
—
P00225831
RAILROAD MEDICARE
OR
Enumeration date
07/17/2006
Last updated
06/30/2008
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