Individual
MRS. JOANN M TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
915 NE VALLEY RD, PULLMAN, WA 99163
(509) 332-3548
(509) 332-5253
Mailing address
915 NE VALLEY RD, PULLMAN, WA 99163-3845
(509) 332-3548
(509) 332-5253
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10003597
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1823905
—
WA
Enumeration date
01/05/2006
Last updated
09/02/2010
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