Organization
PORTLAND INTEGRATIVE PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY FILLEY PMHNP (OWNER)
(503) 765-5856
Entity
Organization
Contact information
Practice address
14523 WESTLAKE DR, 4, LAKE OSWEGO, OR 97035-7700
(503) 765-5856
Mailing address
14523 WESTLAKE DR, 4, LAKE OSWEGO, OR 97035-7700
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201405875
OR
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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