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General NPI Number Information
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NPI Number | 1750194320
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Entity Type | Individual
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Provider Name | TRACY PAIGE PT
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Gender | Female
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 10049 KITSAP MALL BLVD NW
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City | SILVERDALE
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State | WA
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Zip | 98383-8903
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Country | US
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Telephone | 360-373-6966
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Fax |
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Provider Business Mailing Address
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Address Line | 17381 ANGELINE AVENUE SOUTH NE
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City | SUQUAMISH
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State | WA
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Zip | 98392-9747
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Country | US
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Telephone | 585-365-5522
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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 | 00002870
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License Number State | WA
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