Bazan, Tracy
Bazan, Tracy is an individual health care provider with primary practice located at 5050 Ne Hoyt St Ste 315 , Portland OR 97213-2982. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Neuromuscular Medicine. Allopathic & Osteopathic Physicians / Neuromuscular Medicine is her primary health care specialty. Bazan, Tracy can be contacted via phone (503) 215-8580.Contact Information
Primary practice address
5050 Ne Hoyt St Ste 315
Portland OR 97213-2982
Phone: (503) 215-8580
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | MD187129 | Oregon |
| Allopathic & Osteopathic Physicians / Neuromuscular Medicine | 2084N0008X | MD187129 | Oregon |
Profile Details
| NPI number | 1487073789 |
|---|---|
| LBN Legal business name | Bazan, Tracy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 15th, 2014 |
| Last updated | Nov 25th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487073789 | NPPES |
| Oregon | MEDICAID | 500672696 |
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