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General NPI Number Information
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NPI Number | 1700091790
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Entity Type | Individual
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Provider Name | TRACY OUYANG D.D.S
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Gender | Female
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5201 SW WESTGATE DR STE 110
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City | PORTLAND
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State | OR
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Zip | 97221-2424
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Country | US
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Telephone | 503-292-9999
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Fax | 503-292-2088
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Provider Business Mailing Address
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Address Line | 5201 SW WESTGATE DR STE 110
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City | PORTLAND
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State | OR
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Zip | 97221-2424
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Country | US
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Telephone | 503-292-9999
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Fax | 503-292-2088
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D7445
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License Number State | OR
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