Brunette, Tracy Michelle

Brunette, Tracy Michelle is an individual health care provider with primary practice located at 320 Se Baker St , Mcminnville OR 97128-6038. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Brunette, Tracy Michelle can be contacted via phone (503) 474-3600.

Contact Information

Primary practice address
320 Se Baker St Mcminnville OR 97128-6038
Phone: (503) 474-3600
Fax: (503) 474-3601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 201050167 Oregon

Profile Details

NPI number 1912201740
LBN Legal business name Brunette, Tracy Michelle
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2011
Last updated Jun 18th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912201740 NPPES
Oregon MEDICAID 500635439

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