Provider Demographics
NPI:1083401368
Name:GUDDLEBROOK, DEXTER LOCKWOOD (MD, MPH)
Entity type:Individual
Prefix:
First Name:DEXTER
Middle Name:LOCKWOOD
Last Name:GUDDLEBROOK
Suffix:
Gender:
Credentials:MD, MPH
Other - Prefix:
Other - First Name:DEXTER
Other - Middle Name:LOCKWOOD
Other - Last Name:GULICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 LILLY RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5101
Mailing Address - Country:US
Mailing Address - Phone:360-493-7525
Mailing Address - Fax:
Practice Address - Street 1:525 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5101
Practice Address - Country:US
Practice Address - Phone:360-493-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program