MEDICARE: TRACY LYNN HORTMAN LISW-CP,CMSW,LMHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1447	NE
2	1041C0700X	Clinical Social Worker	LW70040157	WA
3	1041C0700X	Clinical Social Worker	14526	SC
4	101YM0800X	Mental Health Counselor	4073	NE

General Provider Information

NPI Number	:	1255522272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY LYNN HORTMAN LISW-CP,CMSW,LMHP

Provider Business Mailing Address
First Line	:	1000 FERN ST SW UNIT C206
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-6123
Country	:	US
Telephone Number	:	402-916-0055
Fax Number	:

Provider Business Practice Location Address
First Line	:	1660 S COLUMBIAN WAY
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-1532
Country	:	US
Telephone Number	:	206-764-2418
Fax Number	:	206-764-2105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2007
Last Update Date	:	12/08/2025

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