Individual
TRACY CAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
566 CEMETERY RD, WINLOCK, WA 98596-9303
(360) 880-7719
Mailing address
566 CEMETERY RD, WINLOCK, WA 98596-9303
(360) 880-7719
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60423213
WA
174400000X
Specialist
—
—
Other
Enumeration date
12/16/2013
Last updated
12/16/2013
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