Healthcare Provider Details

I. General information

NPI: 1952350910
Provider Name (Legal Business Name): TRACY LYNN READ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 MOUNT HOOD AVE
WOODBURN OR
97071-9066
US

IV. Provider business mailing address

1475 MOUNT HOOD AVE
WOODBURN OR
97071-9066
US

V. Phone/Fax

Practice location:
  • Phone: 503-982-2174
  • Fax: 503-982-4599
Mailing address:
  • Phone: 503-982-2174
  • Fax: 503-982-4599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD19842
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: