Healthcare Provider Details

I. General information

NPI: 1386573012
Provider Name (Legal Business Name): LOCKHART SPORTS MEDICINE AND WELLNESS CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 7TH AVE OFC A3
KIRKLAND WA
98033-5665
US

IV. Provider business mailing address

634 7TH AVE OFC A3
KIRKLAND WA
98033-5665
US

V. Phone/Fax

Practice location:
  • Phone: 425-286-4262
  • Fax:
Mailing address:
  • Phone: 425-286-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN LOCKHART
Title or Position: OWNER
Credential: MD
Phone: 425-286-4262