Provider Demographics
NPI:1710562004
Name:SPRADLIN, TRACY (BSN, RN)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:SPRADLIN
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-0400
Mailing Address - Country:US
Mailing Address - Phone:425-831-8040
Mailing Address - Fax:
Practice Address - Street 1:46910 SE MIDDLE FORK RD
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-9745
Practice Address - Country:US
Practice Address - Phone:425-831-4142
Practice Address - Fax:425-831-4140
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00151928163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherSCHOOL NURSE... NEED NPI FOR COVID TESTING