Provider Demographics
NPI:1396377735
Name:WARD, TRACEY KATY (PHD)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:KATY
Last Name:WARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 WESTLAKE AVE N STE 400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-6236
Mailing Address - Country:US
Mailing Address - Phone:356-298-1021
Mailing Address - Fax:
Practice Address - Street 1:1700 WESTLAKE AVE N STE 400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-6236
Practice Address - Country:US
Practice Address - Phone:346-298-1021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61001392103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical