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General NPI Number Information
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NPI Number | 1699275222
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Entity Type | Individual
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Provider Name | TRACI STEVENS DPT
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 18040 SW LOWER BOONES FERRY RD STE 200
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City | TIGARD
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State | OR
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Zip | 97224-7259
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Country | US
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Telephone | 503-216-0680
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Fax | 503-216-0680
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Provider Business Mailing Address
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Address Line | 13040 SW HAYSTACK DR
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City | BEAVERTON
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State | OR
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Zip | 97008-8030
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Country | US
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Telephone | 858-692-1245
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT294359
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 65797
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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