Individual
TRACY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11611 NE AINSWORTH CIR, PORTLAND, OR 97220-9017
(503) 257-1732
Mailing address
3412 NE 48TH AVE, PORTLAND, OR 97213-1841
(608) 358-1347
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
096000108RN
OR
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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