Provider Demographics
NPI:1073856480
Name:FELDSCHER, TRACY LYN
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYN
Last Name:FELDSCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 NE 20TH PL
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-1835
Mailing Address - Country:US
Mailing Address - Phone:503-741-0308
Mailing Address - Fax:
Practice Address - Street 1:567 NE 20TH PL
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-1835
Practice Address - Country:US
Practice Address - Phone:503-741-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker