Individual
AUSTIN M PORTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
2118 E SPRAGUE AVE, SPOKANE, WA 99202-3125
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60859064
WA
101YM0800X
Mental Health Counselor
Primary
LH61020431
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2114397
—
WA
Enumeration date
11/08/2018
Last updated
12/30/2019
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