NPI 1053536268 · live from the CMS NPI Registry
Tracy Funk, MD
Dermatology in Portland, OR. National Provider Identifier 1053536268, active.
NPI record
| NPI | 1053536268 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 3303 Sw Bond Ave # 16d, Ohsu Department Of Dermatology, Portland, OR 97239 |
| Practice phone | 503-418-3376 |
| Enumerated | April 14, 2007 |
| Last updated | June 17, 2015 |
| Sole proprietor | No |
| Other names | Tracy Mcgregor |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics | 208000000X | 47554 (CO) |
| Student in an Organized Health Care Education/Training Program | 390200000X | 47554 (CO) |
| Dermatology primary | 207N00000X | 173370 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.