Provider Demographics
NPI:1811386113
Name:TRANCHITELLA, TRACY (ND)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:TRANCHITELLA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 NW CHARBONNEAU STREET
Mailing Address - Street 2:#201
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703
Mailing Address - Country:US
Mailing Address - Phone:951-461-4800
Mailing Address - Fax:951-461-4560
Practice Address - Street 1:750 NW CHARBONNEAU STREET
Practice Address - Street 2:#201
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702
Practice Address - Country:US
Practice Address - Phone:951-461-4800
Practice Address - Fax:951-461-4560
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3000175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath