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Individual

MISS TRACY OZANICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
23303 HIGHWAY 99 STE G, EDMONDS, WA 98026-8762
(425) 697-5188
(425) 673-1928
Mailing address
1630 228TH ST SE APT E202, BOTHELL, WA 98021-7436
(425) 697-5188
(425) 678-1928

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00016350
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0202662
LABOR & INDUSTRIES PIN#
WA
Enumeration date
01/08/2007
Last updated
07/08/2007
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