Individual
PATRICK LLOYD TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19245 7TH AVE NE, POULSBO, WA 98370-7504
(360) 782-3500
Mailing address
2512 WHEATON WAY, BREMERTON, WA 98310-3399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00017724
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080046467
RAILROAD MEDICARE
—
01
—
49127
LABOR & INDUSTRIES
WA
01
—
5924017
AETNA
—
05
—
8150674
—
WA
01
—
TR0082
REGENCE BLUESHIELD
—
Enumeration date
06/30/2006
Last updated
03/07/2023
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