Jefferson, Tracie Marie
Jefferson, Tracie Marie is an individual health care provider with primary practice located at 11216 Sunrise Blvd E Ste 3-106 , Puyallup WA 98374-8848. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jefferson, Tracie Marie can be contacted via phone (253) 848-5951.Contact Information
Primary practice address
11216 Sunrise Blvd E Ste 3-106
Puyallup WA 98374-8848
Phone: (253) 848-5951
Fax: (253) 845-7073
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA60596875 | Washington |
Profile Details
| NPI number | 1346642832 |
|---|---|
| LBN Legal business name | Jefferson, Tracie Marie |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 16th, 2014 |
| Last updated | Aug 24th, 2017 - about 9 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 | 1346642832 | NPPES |
| Washington | MEDICAID | 2048296 |
Popular Providers
-
Prater, Donald Edward
3908 10Th St Se , Puyallup WA 98374-2188 -
Arvelo, Ednorah M
11025 Canyon Rd E Suite A, Puyallup WA 98373-4268 -
Zamora, Adriana L
3908 10Th St Se , Puyallup WA 98374-2188 -
Portalski, Nicholas
1007 39Th Ave Se , Puyallup WA 98374-2192 -
Fawcett, Shayla
11216 Sunrise Blvd E Ste 3-207 , Puyallup WA 98374-8848 -
Clarno, Megan
3908 10Th St Se , Puyallup WA 98374-2188 -
Henderson, Margaret M
3908 10Th St Se , Puyallup WA 98374-2188 -
Rapier, Jared Collin
11216 Sunrise Blvd E #3-106, Puyallup WA 98374-8848