Individual
TRACY LEE STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM/WHNP
Contact information
Practice address
2222 NE 130TH AVE, PORTLAND, OR 97230-1705
(503) 754-6296
Mailing address
2222 NE 130TH AVE, PORTLAND, OR 97230-1705
(503) 754-6296
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
201903006NP-PP
OR
367A00000X
Advanced Practice Midwife
Primary
201901674NP-PP
OR
Other
Enumeration date
06/23/2019
Last updated
06/23/2019
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