Provider Demographics
NPI:1689495467
Name:HAY, TRACEY MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:MICHELLE
Last Name:HAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6905 ALPINE WAY
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-1636
Mailing Address - Country:US
Mailing Address - Phone:509-952-0581
Mailing Address - Fax:
Practice Address - Street 1:6905 ALPINE WAY
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-1636
Practice Address - Country:US
Practice Address - Phone:509-952-0581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00150058163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse