Individual
TRACY LUTTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 WILSON ST, LAFAYETTE, OR 97127-9199
(971) 237-6468
Mailing address
1107 WILSON ST, LAFAYETTE, OR 97127-9199
(971) 237-6468
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
201705789RN
OR
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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