Mercedes Tracy
Behavior Technician in Portland, OR. Individual provider (NPI-1).
NPI number1164035119
StatusActive
Last updated in NPPESAug 28, 2020
Details
- NPI
- 1164035119
- Entity type
- Individual (NPI-1)
- Name
- Mercedes Tracy
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 28, 2020
- Certification date
- Aug 28, 2020
- Last updated
- Aug 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
5457 Sw Canyon CtPortland, OR 97221-2401
Phone 971-762-4663
Mailing address
5457 Sw Canyon CtPortland, OR 97221-2401
Phone 971-762-4663
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