Granston, Traci Suzanne
Granston, Traci Suzanne is an individual health care provider with primary practice located at 4011 Talbot Rd S Ste 300 , Renton WA 98055-5791. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Hand Surgery. Allopathic & Osteopathic Physicians / Hand Surgery is her primary health care specialty. Granston, Traci Suzanne can be contacted via phone (425) 656-5060.Contact Information
Primary practice address
4011 Talbot Rd S Ste 300
Renton WA 98055-5791
Phone: (425) 656-5060
Fax: (425) 656-5047
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD00039700 | Washington |
| Allopathic & Osteopathic Physicians / Hand Surgery | 207XS0106X | MD00039700 | Washington |
Profile Details
| NPI number | 1023089075 |
|---|---|
| LBN Legal business name | Granston, Traci Suzanne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 29th, 2006 |
| Last updated | Jan 5th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023089075 | NPPES |
| Washington | MEDICAID | 1090604 | |
| Washington | Other | 160279 |
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