Individual
TRACY L BUSEMAN-CARLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5211 NE GLISAN ST BLDG C, PORTLAND, OR 97213-3052
(503) 869-4228
Mailing address
9580 SW WASHINGTON PL, PORTLAND, OR 97225-6936
(503) 869-4228
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/15/2018
Last updated
01/15/2018
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