Individual ProviderTracey Lynn WilcoxPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address5005 Ruston Way, Ste 125, Tacoma, WA 98402-5314(253) 759-4522PECOS EnrollmentBased on the most recent information from CMS, provider Tracey Lynn Wilcox does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1881675015Provider TypeIndividualFull NameWilcox, Tracey LynnCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date11/5/2005Last Updated2/20/2015Contact InformationPractice LocationPractice Address5005 Ruston Way, Ste 125, Tacoma, WA 98402-5314Phone(253) 759-4522Fax(253) 759-4699Mailing LocationMailing Address5005 Ruston Way, Ste 125, Tacoma, WA 98402-5314Phone(253) 759-4522Fax(253) 759-4699Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense60413586WashingtonCode363AM0700XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA9102446FloridaProvider IdentifiersIDDescriptionIssuerID2916622000DescriptionMedicaidIssuerUnlistedFloridaID336140DescriptionOtherIssuerSTATE L&IWashington