Berg, Tracy A
Berg, Tracy A is an sole proprietor health care provider with primary practice located at 16201 E Indiana Ave Ste 3100, Spokane Valley WA 99216-2830. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as her primary health care specialty. Berg, Tracy A can be contacted via phone (509) 891-8904.Contact Information
Primary practice address
16201 E Indiana Ave Ste 3100
Spokane Valley WA 99216-2830
Phone: (509) 891-8904
Fax: (509) 344-3104
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | MD00032615 | Washington |
Profile Details
| NPI number | 1376637421 |
|---|---|
| LBN Legal business name | Berg, Tracy A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Dec 2nd, 2016 - about 8 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 | 1376637421 | NPPES |
| Washington | MEDICAID | 1123884 |
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