Individual
MERCEDES TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5457 SW CANYON CT, PORTLAND, OR 97221-2401
(971) 762-4663
Mailing address
5457 SW CANYON CT, PORTLAND, OR 97221-2401
(971) 762-4663
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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