Individual
CHRISTOPHER R PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD00040884
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039595
LABOR AND INDUSTRIES #
WA
01
—
7561PO
BLUE SHIELD #
WA
05
—
8317430
—
WA
01
—
8893529
MEDICARE PTAN
WA
05
—
MD9271W
—
AK
01
—
US2852383
AETNA SPECIALIST PIN
WA
Enumeration date
10/01/2006
Last updated
10/07/2010
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