Healthcare Provider Details

I. General information

NPI: 1275999294
Provider Name (Legal Business Name): DANIELLE SMITH LOCKWOOD N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2016
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 NE 6TH AVE
CAMAS WA
98607-2037
US

IV. Provider business mailing address

240 W HAYDEN AVE STE E #102
HAYDEN ID
83835-8126
US

V. Phone/Fax

Practice location:
  • Phone: 360-818-9095
  • Fax:
Mailing address:
  • Phone: 360-818-9095
  • Fax: 503-549-8971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC175296
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC61161145
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNMD-0056
License Number StateID
# 4
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number3066
License Number StateOR
# 5
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT61140561
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: