Individual
TRACY WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2099
(503) 571-4506
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10054809
OR
163W00000X
Registered Nurse
RN744405
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
10054809
OR
Other
Enumeration date
01/09/2023
Last updated
04/21/2026
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