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NPI Code Detail

MEDICARE: DR. JESSICA RENEE LOCKE ARNP, PHD

MEDICARE: DR. JESSICA RENEE LOCKE ARNP, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner10007108OR
2363LF0000XFamily Nurse PractitionerARNP9249745FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346412152
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA RENEE LOCKE ARNP, PHD
Provider Business Mailing Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number : 503-494-7772
Fax Number :
Provider Business Practice Location Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number : 503-494-7772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2008
Last Update Date : 01/28/2026

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