Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tracy Broomell, DPT

Individual provider Physical Therapist · NPI 1861977530

Tracy Broomell, DPT is a Physical Therapist in Private Practice in Keizer, Oregon. Qualified in 2018, 8 years ago. Practices with Fireweed Therapy LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Michigan and Oregon.

Years since qualifying
8
Licensed in
MI, OR
In the registry since
2018
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4025 Cherry Ave NE
Keizer, OR 97303-4859
Phone: (503) 390-9009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 62970 (OR)
Physical Therapist Taxonomy 225100000X · Licence 5501018836 (MI)

Record details

NPI number1861977530
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 28, 2018
Last updated in NPPESSeptember 28, 2018
Mailing address7614 Ravenswood Dr, Portage, MI 49024-5020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Fireweed Therapy Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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