Active NPI
Jill Jacqueline Locke, PHD
- Psychologist
- Seattle, WA
National Provider Identifier
1609485242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 60919089
- Practice address
- 4909 25TH Ave NE
Seattle, WA 98105-4107 - Phone
- (206) 987-8080
- NPI assigned
- Jul 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 60919089 | WA | Primary |
Addresses
Primary practice location
4909 25TH Ave NE
Seattle, WA 98105-4107
Mailing address
5526 34TH Ave NE
Seattle, WA 98105-2305
Phone (818) 384-3554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60919089 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595980800000",
"number": "1609485242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5526 34TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981052305",
"telephone_number": "818-384-3554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4909 25TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981054107",
"telephone_number": "206-987-8080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKE",
"first_name": "JILL",
"middle_name": "JACQUELINE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-29",
"last_updated": "2020-07-29",
"certification_date": "2020-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "60919089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.