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General NPI Number Information
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NPI Number | 1609357813
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Entity Type | Individual
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Provider Name | TRACY LE
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Gender | Female
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Dates
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Enumeration Date | 08/25/2018
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 140 SW 146TH ST
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City | BURIEN
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State | WA
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Zip | 98166-1912
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Country | US
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Telephone | 206-630-3000
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Fax | 206-630-3001
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Provider Business Mailing Address
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Address Line | 201 16TH AVENUE EAST
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City | SEATTLE
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State | WA
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Zip | 98112
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Country | US
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Telephone | 206-326-3000
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Fax | 206-326-4845
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP60882882
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License Number State | WA
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