Individual
TRACEE JON DAHLKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
320 SW 2ND ST, CORVALLIS, OR 97333-4632
(541) 207-3709
Mailing address
32949 WILDROSE DR, TANGENT, OR 97389-9518
(808) 265-5970
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202202434NP-PP
OR
363LS0200X
School Nurse Practitioner
201509445RN
OR
Other
Enumeration date
03/20/2020
Last updated
03/16/2022
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