Doctor Name: | TRACY LEE MOSER |
NPI Number: | 1033328687 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | LL00002591 |
Business Practice Address: | 6511 Ne 18th St Vancouver, WA - 986616869 |
Business Phone Number: | 3607594917 |
Business Fax Number: | 3607594921 |
Mailing Address: | 3564 Nw Lansbrook Ter, PORTLAND |
State: | OR |
Postal Code: | 972293772 |
Phone Number: | 5034399434 |
Fax Number: | |
NPI Enumeration Date: | 05/21/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | LL00002591 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |