Provider Demographics
NPI:1568867604
Name:TRACY, LINSEY
Entity Type:Individual
Prefix:
First Name:LINSEY
Middle Name:
Last Name:TRACY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINSEY
Other - Middle Name:
Other - Last Name:MCLENNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:37624 SE FURY ST
Mailing Address - Street 2:# C-201
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9680
Mailing Address - Country:US
Mailing Address - Phone:425-450-9474
Mailing Address - Fax:
Practice Address - Street 1:37624 SE FURY ST
Practice Address - Street 2:STE C201
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9680
Practice Address - Country:US
Practice Address - Phone:425-292-0223
Practice Address - Fax:425-292-9225
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT:60459586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist