Individual
TRACI CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
16679 NW NORWALK DR, BEAVERTON, OR 97006-5280
(503) 332-8131
Mailing address
16679 NW NORWALK DR, BEAVERTON, OR 97006-5280
(503) 332-8131
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1070557
OR
Other
Enumeration date
04/07/2015
Last updated
12/27/2021
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