Provider Demographics
NPI:1952560328
Name:ADKINS, TRACY LYNN (ARNP-C)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LYNN
Last Name:ADKINS
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:VONBARGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1221 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-2829
Mailing Address - Country:US
Mailing Address - Phone:509-758-5511
Mailing Address - Fax:509-751-0314
Practice Address - Street 1:1221 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2829
Practice Address - Country:US
Practice Address - Phone:509-758-5511
Practice Address - Fax:509-751-0314
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60029830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily