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Contact Information

TRACEY K TRACY, MD
506 4TH ST
LA GRANDE, OR97850
 Phone: 541-663-3138
 Fax: 541-975-5120
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for TRACEY K TRACY · (Female)

NPI # 1073760955
Status Active
Credentials MD
Entity Individual
Enumeration date 08/22/2008
Last updated 04/05/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • OR License # MD151037
  • WA License # MD60747878
  • OR Medicaid 500620109
  • OR Other P00965892 RR MEDICARE
Hospital affiliation(s)
  • GRANDE RONDE HOSPITAL - (Critical Access)
    900 SUNSET DRIVE
    LA GRANDE, OR 97850
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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