TRACY A BERG (NPI# 1376637421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376637421 |
| Entity Type | Individual |
| Full Name | TRACY A BERG |
| Other Name | TRACY A MAGNUSON |
| Credential | M.D. |
| Practice Address |
16201 E Indiana Ave Ste 3100 Spokane Valley WA 99216-2830 |
| Practice Telephone | 5098918904 |
| Practice Fax Number | 5093443104 |
| Mailing Telephone | 5098918904 |
| Mailing Fax Number | 5093443104 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-12-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD00032615 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1123884 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467068916 | Tracy Marvin Berg IIi | Massage Therapist | 2700 Dorr Ave Apt 526, Fairfax, VA 22031-4946 | 2020-09-21 |
| 1427031624 | Tracy M Berg | Pharmacist | Mayo Clinic Pharmacy, 200 First Street Sw, Rochester, MN 55905-0001 | 2005-11-22 |
| 1134437023 | Tracy Berg | Physical Therapy Assistant | 250 G St, Blaine, WA 98230-4019 | 2010-09-14 |
| Street Address |
16201 E INDIANA AVE STE 3100 |
| City | SPOKANE VALLEY |
| State | WA |
| Zip Code | 99216-2830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578093407 | Taylor G Hanson | Massage Therapist | 16201 E Indiana Ave, Spokane Valley, WA 99216-2830 | 2017-06-13 |
| 1417490392 | Angelos Investments, LLC | Clinic/Center | 16201 E Indiana Ave, #3260, Spokane Valley, WA 99216-2830 | 2016-11-28 |
| 1891145280 | New Leaf Hyperbarics of Spokane Valley | Clinic/Center | 16201 E Indiana Ave, 3260, Spokane Valley, WA 99216-2830 | 2016-06-15 |
| 1053701334 | Premier Psychiatric Services, Pllc | Psychiatry & Neurology | 16201 E Indiana Ave, Suite 5300, Spokane Valley, WA 99216-2830 | 2015-01-26 |
| 1972851020 | Spokane Optical Company LLC | Eyewear Supplier (Equipment, not the service) | 16201 E Indiana Ave, 5000, Spokane Valley, WA 99216-2830 | 2012-08-21 |
| 1043410194 | Northwest Health Summit, Ps | Physician Assistant | 16201 E Indiana Ave, Suite 5300, Spokane Valley, WA 99216-2830 | 2007-07-18 |
| 1699980367 | Mark Andrew Hiesterman | Surgery | 16201 E Indiana Ave, Suite 3100, Spokane Valley, WA 99216-2830 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053920124 | Aark Laboratory | Clinical Medical Laboratory | 12709 E Mirabeau Pkwy Bldg A Ste 500, Spokane, WA 99216 | 2020-07-24 |
| 1922622158 | Vera Whole Health Wa, PC | Clinic/Center | 16009 E Indiana Ave, Spokane Valley, WA 99216 | 2020-06-03 |
| 1023654001 | Rebecca Elizabeth Ryan | Massage Therapist | 12505 E 23rd Ave, Spokane Valley, WA 99216 | 2019-11-25 |
| 1356992903 | Creative Communication LLC | Speech-Language Pathologist | 13607 E. Sprague Ave, Spokane Valley, WA 99216 | 2019-09-25 |
| 1972096584 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 15319 E Indiana Ave Ste 2, Spokane Valley, WA 99216 | 2018-06-08 |
| 1356845655 | Rp Operations, LLC | Assisted Living Facility | 13013 E Mission Ave, Spokane Valley, WA 99216 | 2018-03-21 |
| 1174036305 | Talk, Learn and Communicate | Speech-Language Pathologist | 13607 East Spraque Avenue, Spokane Valley, WA 99216 | 2017-11-09 |
| 1134638281 | Vtc Vitality Healthcare | Pain Medicine | 12409 E Mission Ave Ste 102, Spokane Valley, WA 99216 | 2017-09-20 |
| 1285150086 | Robert C Tsay Jr. | Pharmacist | 12415 E 12th Ave, Apt 110, Spokane Valley, WA 99216 | 2017-08-15 |
| 1629505607 | Spokane Valley Medical, Inc | Durable Medical Equipment & Medical Supplies | 12509 E. Mission Ave, Suite #103, Spokane, WA 99216 | 2017-05-22 |
| Find all providers in zip 99216 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496922 | Sunnyside Community Hospital Association | Surgery | 1005 W Walnut St Ste 201, Yakima, WA 98902-3384 | 2017-09-20 |
| 1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
| 1356722938 | Usa Vascular Centers of Kent Pllc | Surgery | 26124a Pacific Hwy S Ste A, Kent, WA 98032-6910 | 2015-06-09 |
| 1154602084 | Memorial Physicians, Pllc | Surgery | 1812 E Edison Ave, Sunnyside, WA 98944-1653 | 2011-09-06 |
| 1528387941 | Sara Jane Wasilenko | Surgery | 128 Lilly Rd Ne Ste 205, Olympia, WA 98506-7400 | 2010-05-25 |
| 1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
| 1013104165 | John S Arthur | Surgery | 2528 Wheaton Way Ste 101, Bremerton, WA 98310-3305 | 2007-10-02 |
| 1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
| 1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
| 1649491481 | Dae Young Lee | Surgery | 1100 Goethals Drive 3rd Floor, Kadlec Clinic Vascular Surgery, Richland, WA 99352-3304 | 2007-05-01 |
| Find all providers with the same taxonomy | ||||
| City | SPOKANE VALLEY |
| Zip Code | 99216 |
Please comment or provide details below to improve the information on TRACY A BERG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.