Provider Demographics
NPI:1568616878
Name:TRACY, JOSIE JO (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSIE
Middle Name:JO
Last Name:TRACY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:JO
Other - Last Name:TRACY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:MAIL STOP: S-116-DDTP
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1532
Mailing Address - Country:US
Mailing Address - Phone:206-277-3650
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:MAIL STOP: S-116-DDTP
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-277-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)