Basic Information
| Provider Information | |||||||||
| NPI: | 1568867604 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRACY | ||||||||
| FirstName: | LINSEY | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | MCLENNAN | ||||||||
| OtherFirstName: | LINSEY | ||||||||
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| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 37624 SE FURY ST | ||||||||
| Address2: | # C-201 | ||||||||
| City: | SNOQUALMIE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980659680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254509474 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 37624 SE FURY ST | ||||||||
| Address2: | STE C201 | ||||||||
| City: | SNOQUALMIE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980659680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252920223 | ||||||||
| FaxNumber: | 4252929225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2014 | ||||||||
| LastUpdateDate: | 12/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT:60459586 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.