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Individual
TRACY MOCK
Active
Individual
TRACY MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00018024
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2026868
—
WA
Enumeration date
05/15/2013
Last updated
07/21/2014
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