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General NPI Number Information
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NPI Number | 1255522272
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Entity Type | Individual
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Provider Name | TRACY LYNN HORTMAN LISW-CP,CMSW,LMHP
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Gender | Female
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1660 S COLUMBIAN WAY
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City | SEATTLE
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State | WA
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Zip | 98108-1532
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Country | US
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Telephone | 206-764-2418
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Fax | 206-764-2105
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Provider Business Mailing Address
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Address Line | 1000 FERN ST SW UNIT C206
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City | OLYMPIA
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State | WA
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Zip | 98502-6123
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Country | US
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Telephone | 402-916-0055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1447
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW70040157
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14526
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4073
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License Number State | NE
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