Tracie Brockey, DPT
Individual provider Active NPI Physical Therapist · Astoria, OR
NPI 1417739764 · NPPES record last updated Oct 19, 2023
Key facts
- NPI
- 1417739764
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 60251 (OR)
- Practice address
- 2265 Exchange St
Astoria, OR 97103-3331 - Phone
- (503) 338-7555
- Fax
- (503) 338-7557
- NPI assigned
- Oct 19, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60251 | OR | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 60251 | OR | Yes |
Addresses
Primary practice location
2265 Exchange St
Astoria, OR 97103-3331
Mailing address
2265 Exchange St
Astoria, OR 97103-3331
Phone (503) 338-7555
Other providers in Astoria, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.