Healthcare Provider Details

I. General information

NPI: 1962544049
Provider Name (Legal Business Name): TRACY A LLOYD P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5025 25TH AVE NE SUITE 201
SEATTLE WA
98105-4151
US

IV. Provider business mailing address

6056 33RD AVE NE
SEATTLE WA
98115-7305
US

V. Phone/Fax

Practice location:
  • Phone: 206-524-6702
  • Fax: 206-524-6703
Mailing address:
  • Phone: 206-524-6702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00003216
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: