Individual
TRACY LYNN DELORM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
9421 N DAVIES RD, LAKE STEVENS, WA 98258-9444
(425) 334-4001
(425) 335-4003
Mailing address
9421 N DAVIES RD, LAKE STEVENS, WA 98258-9444
(425) 334-4001
(425) 335-4003
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9086
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9086
LICENSE NUMBER
WA
01
—
UNITED CONCORDIA
1434898
WA
Enumeration date
10/02/2006
Last updated
07/08/2007
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