Individual
TRACY L ESTRELLADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 765-0216
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10002438
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083645733
—
WA
01
—
127396
L&I
WA
01
—
314838
L&I POST 7/21/13
WA
01
—
P01257588
RR MEDICARE
WA
Enumeration date
07/05/2006
Last updated
06/20/2022
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