Individual
TRACI MATTOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
903 S ADAMS ST, RITZVILLE, WA 99169-2227
(509) 659-5408
(509) 659-0522
Mailing address
903 S ADAMS ST, RITZVILLE, WA 99169-2227
(509) 659-5408
(509) 659-0522
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
NC10083060
WA
Other
Enumeration date
02/23/2016
Last updated
02/23/2016
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