Provider Demographics
NPI:1740596378
Name:DOWELL, TRACY JUNE (COPES)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:JUNE
Last Name:DOWELL
Suffix:
Gender:F
Credentials:COPES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9042 37TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-4811
Mailing Address - Country:US
Mailing Address - Phone:206-856-0966
Mailing Address - Fax:
Practice Address - Street 1:9042 37TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-4811
Practice Address - Country:US
Practice Address - Phone:206-856-0966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver