Provider Demographics
NPI:1093471922
Name:TREMBLAY, RAEGAN (MD, MPH)
Entity type:Individual
Prefix:
First Name:RAEGAN
Middle Name:
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 S ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5232
Mailing Address - Country:US
Mailing Address - Phone:918-760-0160
Mailing Address - Fax:
Practice Address - Street 1:850 REPUBLICAN ST # 358047
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4725
Practice Address - Country:US
Practice Address - Phone:206-668-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMDRE.ML.61679335207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine