Provider Demographics
NPI:1518016195
Name:LOCKWOOD, SHELLEY MARIA (ARNP)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:MARIA
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 POINT FOSDICK DR NW
Mailing Address - Street 2:#102
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1706
Mailing Address - Country:US
Mailing Address - Phone:253-853-2050
Mailing Address - Fax:253-853-2711
Practice Address - Street 1:4700 POINT FOSDICK DR NW
Practice Address - Street 2:#102
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1706
Practice Address - Country:US
Practice Address - Phone:253-853-2050
Practice Address - Fax:253-853-2711
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007445363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily