Provider Demographics
NPI:1952418220
Name:LOKER, EDWARD FRANK JR (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:FRANK
Last Name:LOKER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14208 NW 55TH CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-1191
Mailing Address - Country:US
Mailing Address - Phone:415-572-3390
Mailing Address - Fax:
Practice Address - Street 1:14208 NW 55TH CT
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-1191
Practice Address - Country:US
Practice Address - Phone:415-572-3390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00020461207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G63914Medicaid
CA00G63914Medicaid
CAD67335Medicare UPIN