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Individual

CHRISTOPHER R PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 OLIVE WAY # MS /M4-PA, SEATTLE, WA 98101-1873
(206) 515-5811

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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