Individual
TYRON TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4915 SW GRIFFITH DR STE 304, BEAVERTON, OR 97005-2933
(503) 620-5614
(503) 598-4688
Mailing address
7320 SW HUNZIKER RD STE 300, PORTLAND, OR 97223-2302
(503) 941-3033
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA170039
OR
Other
Enumeration date
07/10/2013
Last updated
11/26/2024
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