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General NPI Number Information
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NPI Number | 1306608641
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Entity Type | Individual
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Provider Name | JASMINE LOCKETT
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Gender | Female
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 13765 VINTAGE DR SW
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City | PORT ORCHARD
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State | WA
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Zip | 98367-7391
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Country | US
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Telephone | 808-688-3897
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Fax |
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Provider Business Mailing Address
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Address Line | 17814 25TH AVENUE CT E
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City | TACOMA
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State | WA
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Zip | 98445-4288
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Country | US
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Telephone | 808-688-3897
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | LABA.AB.70048750
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License Number State | WA
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