Most Relevant Information
Provider Data
| NPI Number: | 1003240078 |
| Provider Name: | TRACY LEIGH CHISHOLM PSY.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | 001273 |
Most Important Dates
| Enumeration Date: | 08/27/2013 |
| Last Updated: | 08/27/2013 |
Provider Practice Location
22400 JOHNSON RD
WEST LINN
OR
970689722
Practice Location Phone/Fax
| Phone: | 8502945733 |
| Fax: |
Provider Mailing Location
22400 JOHNSON RD
WEST LINN
OR
970689722
Provider Mailing Phone/Fax
| Phone: | 8502945733 |
| Fax: |