Individual
TRACIE JILL MCCALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3939 NE HANCOCK ST STE 307, PORTLAND, OR 97212-5321
(503) 805-3303
Mailing address
1850 SE 45TH AVE, PORTLAND, OR 97215-3137
(503) 805-3303
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3907
OR
Other
Enumeration date
01/29/2009
Last updated
01/29/2009
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