TRACY BAZAN (NPI# 1487073789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487073789 |
| Entity Type | Individual |
| Full Name | TRACY BAZAN |
| Credential | MD |
| Practice Address |
10330 Se 32nd Ave Ste 226 Milwaukie OR 97222-6699 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5035138020 |
| Mailing Telephone | 5032156494 |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2019-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD187129 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500672696 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3181 Sw Sam Jackson Park Rd, Portland, OR 972393011 | 5034948211 |
| Street Address |
10330 SE 32ND AVE STE 226 |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97222-6699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952586869 | Providence Health & Services - Oregon | Psychiatry & Neurology | 10330 Se 32nd Ave, Suite 226, Milwaukie, OR 97222-6699 | 2008-01-09 |
| 1598884033 | Clyde Mitchell Finch | Psychiatry & Neurology | 10202 Se 32nd Ave, Ste 703, Milwaukie, OR 97222-3625 | 2007-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639690704 | Tuality Medical Group LLC | Psychiatry & Neurology | 364 Se 8th Ave Ste 101, Hillsboro, OR 97123-4243 | 2017-06-29 |
| 1659891455 | Weller Neurology LLC | Psychiatry & Neurology | 24900 Se Stark St Ste 211, Gresham, OR 97030-3382 | 2017-06-22 |
| 1750739132 | Neil William Douglas Thomas | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Road, Cr131, Oregon Health and Science University, Portland, OR 97239 | 2016-05-26 |
| 1205283462 | Candice Kam | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Road, Cr-131s, Portland, OR 97239 | 2016-05-18 |
| 1881937050 | Michael Saul Farris | Psychiatry & Neurology | Ohsu-3181 Sw Sam Jackson Park Road, Portland, OR 97239 | 2013-04-05 |
| 1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
| 1831460377 | Dennis B Smith | Psychiatry & Neurology | 827 Nw 25th Ave, Portland, OR 97210-3808 | 2012-01-13 |
| 1790078608 | George Reeves Throop IIi | Psychiatry & Neurology | 1142 Nw Scenic Dr, Albany, OR 97321-9669 | 2011-05-25 |
| 1992000228 | Ruchi J Wanchoo | Psychiatry & Neurology | 19260 Sw 65th Ave Ste 280, Tualatin, OR 97062 | 2011-01-18 |
| 1366683187 | Megan Christine Alcauskas | Psychiatry & Neurology | 855 G Ave, Lake Oswego, OR 97034-2258 | 2009-03-09 |
| Find all providers with the same taxonomy | ||||
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| 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.