Individual
DESIREE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
16123 SE MCKINLEY AVE, CLACKAMAS, OR 97015-9418
(562) 726-5104
Mailing address
16123 SE MCKINLEY AVE, CLACKAMAS, OR 97015-9418
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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