Provider Demographics
NPI:1033609912
Name:TRACY, HARMONY RACHEL (OBLMT)
Entity Type:Individual
Prefix:MRS
First Name:HARMONY
Middle Name:RACHEL
Last Name:TRACY
Suffix:
Gender:F
Credentials:OBLMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-9570
Mailing Address - Country:US
Mailing Address - Phone:541-480-2767
Mailing Address - Fax:
Practice Address - Street 1:1680 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-9570
Practice Address - Country:US
Practice Address - Phone:541-480-2767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR21211225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist