Provider Demographics
NPI:1346422235
Name:POZAR, TRACY ELIZABETH (CFNP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ELIZABETH
Last Name:POZAR
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:ELIZABETH
Other - Last Name:YUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:PO BOX 905
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0905
Mailing Address - Country:US
Mailing Address - Phone:970-389-5570
Mailing Address - Fax:888-342-6115
Practice Address - Street 1:215 SW 10TH ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-1929
Practice Address - Country:US
Practice Address - Phone:970-389-5570
Practice Address - Fax:888-342-6115
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104721394261QH0100X
OR2010410067363L00000X
OR201050067NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner