Estrellado, Tracy L
Estrellado, Tracy L is an individual health care provider with primary practice located at 840 E Hill Ave , Moses Lake WA 98837-2238. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Estrellado, Tracy L can be contacted via phone (509) 765-0216.Contact Information
Primary practice address
840 E Hill Ave
Moses Lake WA 98837-2238
Phone: (509) 765-0216
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA10002438 | Washington |
Profile Details
| NPI number | 1083645733 |
|---|---|
| LBN Legal business name | Estrellado, Tracy L |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Jun 20th, 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 | 1083645733 | NPPES |
| Washington | Other | 314838 | L&I POST 7/21/13 |
| Washington | Other | P01257588 | L&I POST 7/21/13 |
| Washington | MEDICAID | 1083645733 | L&I POST 7/21/13 |
| Washington | Other | 127396 | L&I POST 7/21/13 |
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