Individual
TRACY WILLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
110 MAIN ST, MORO, OR 97039-3115
(541) 565-3325
(541) 565-3617
Mailing address
PO BOX 186, MORO, OR 97039-0186
(541) 565-3325
(541) 565-3617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
126295
OR
Other
Enumeration date
10/20/2005
Last updated
05/10/2021
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