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1679023519
TRACY DODGE
PORTLAND, OR
NPI
1679023519
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: OR PA190591)
Enumeration Date
2016-10-04
Last Update Date
2019-07-11
Business Address
TRACY DODGE PA-C, MPH
727 W BURNSIDE ST
PORTLAND, OR 97209-3514
Phone number: 503-228-4533
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Mailing Address
TRACY DODGE PA-C, MPH
727 W BURNSIDE ST
PORTLAND, OR 97209-3514
Phone number: 503-228-4533
Copy
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