Russell, Tracy Lynne
Russell, Tracy Lynne is an individual health care provider with primary practice located at 611 N F St Ste 201, Aberdeen WA 98520-2667. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Russell, Tracy Lynne can be contacted via phone (360) 533-7677.Contact Information
Primary practice address
611 N F St Ste 201
Aberdeen WA 98520-2667
Phone: (360) 533-7677
Fax: (360) 533-0470
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00046873 | Washington |
Profile Details
| NPI number | 1629040894 |
|---|---|
| LBN Legal business name | Russell, Tracy Lynne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 2nd, 2006 |
| Last updated | Jul 19th, 2011 - about 15 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 | 1629040894 | NPPES |
| Washington | MEDICAID | 1123256 |
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