Individual
TRACI GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED ASSOCIATE
Contact information
Practice address
LIFESTANCE HEALTH, 880 82ND DRIVE, GLADSTONE, OR 97027
(503) 659-5515
Mailing address
15315 SE LEE AVE, MILWAUKIE, OR 97267-2639
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
R9311
OR
Other
Enumeration date
06/06/2024
Last updated
09/26/2024
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