Provider Demographics
NPI:1093906257
Name:LOCKE, CESALEE YARROW (LMT)
Entity Type:Individual
Prefix:
First Name:CESALEE
Middle Name:YARROW
Last Name:LOCKE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4825
Mailing Address - Country:US
Mailing Address - Phone:509-954-1030
Mailing Address - Fax:
Practice Address - Street 1:22 W INDIANA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-4825
Practice Address - Country:US
Practice Address - Phone:509-954-1030
Practice Address - Fax:509-326-2571
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024557225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist