Healthcare Provider Details

I. General information

NPI: 1427048651
Provider Name (Legal Business Name): TRACY S MCDANIEL ND,LM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6327 22ND AVE NE
SEATTLE WA
98115-6919
US

IV. Provider business mailing address

6327 22ND AVE NE
SEATTLE WA
98115-6919
US

V. Phone/Fax

Practice location:
  • Phone: 206-363-5555
  • Fax: 206-363-5533
Mailing address:
  • Phone: 206-363-5555
  • Fax: 206-363-5533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT1136
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: