Tracy Jane Dodgen I, is a
Registered Nurse based in Parkland, Washington. Tracy Jane Dodgen I is licensed to practice in California (license number 95221355) and her current practice location is
14016 A St S, Parkland, Washington. She can be reached at her office (for appointments etc.) via phone at
(949) 395-8584.
NPI number for Tracy Jane Dodgen I is 1578261038 and her current mailing address is 15131 Ficus St, Lake Elsinore, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1578261038.
Provider's Profile
| Full Name | Tracy Jane Dodgen I |
|---|
| Gender | Female |
|---|
| Speciality | Registered Nurse |
|---|
| Location | 14016 A St S, Parkland, Washington |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1578261038
- Provider Enumeration Date: 02/22/2023
- Last Update Date: 08/30/2024
Medical Identifiers
Medical identifiers for Tracy Jane Dodgen I such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1578261038 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 163W00000X | Registered Nurse | 95221355 (California) | Primary |
| 163WP0808X | Registered Nurse - Psychiatric/mental Health | 61404087 (Washington) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tracy Jane Dodgen I is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Tracy Jane Dodgen I, 15131 Ficus St, Lake Elsinore, CA 92530-7338 Ph: (949) 395-8584 | Tracy Jane Dodgen I, 14016 A St S, Parkland, WA 98444-4662 Ph: (949) 395-8584 |
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