Individual
DR. TRACY HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4212 NE BROADWAY, PORTLAND, OR 97213
(503) 249-8787
(503) 382-7706
Mailing address
7823 N ALBINA AVE, PORTLAND, OR 97217-1111
(541) 207-6930
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
PG178431
OR
Other
Enumeration date
05/06/2016
Last updated
07/02/2019
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