DR. ROBERT E. TRACY D.D.S. P.S. NPI 1962647578

NPI Information

NPI: 1962647578
Provider Name: DR. ROBERT E. TRACY D.D.S., P.S.
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
11066 5TH AVE NE
SUITE 200
SEATTLE, WA
ZIP 98125
Phone: (206) 362-3833
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DR. ROBERT E. TRACY D.D.S., P.S. is a dental clinic center in Seattle, WA. DR. ROBERT E. TRACY D.D.S., P.S. NPI is 1962647578. The provider is registered as an organization entity type.

The provider's business location address is:

11066 5TH AVE NE
SUITE 200
SEATTLE, WA
ZIP 98125-156
Phone: (206) 362-3833
Fax: (206) 362-3834

The provider's authorized official is Robert E. Tracy .
The authorized official title is Sole Proprietor and has the following contact phone number (206) 362-3833.

The enumeration date for this NPI number is 12/10/2008 and was last updated on 12/10/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	4990	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	WASHINGTON	TAX ID
2	970226	OTHER	WASHINGTON	UNITED CONCORDIA PROVIDER ID
3	4990	OTHER	WASHINGTON	LISCENCE
4	5002043	OTHER	WASHINGTON	MEDICAID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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