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Individual

MS. TRACY LYN FRITTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICAL THERAPIST

Contact information

Practice address
4560 SE INTERNATIONAL WAY, CONSONUS REHAB SERVICES SUITE 100, MILWAUKIE, OR 97222
(971) 206-5140
(971) 206-5209
Mailing address
4560 SE INTERNATIONAL WAY, SUITE 100, MILWAUKIE, OR 97222
(971) 206-5140
(971) 206-5209

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2590
OR
225100000X
Physical Therapist
PT 00008778
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
116595
OR
Enumeration date
01/08/2007
Last updated
07/08/2007
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