Individual
MR. JEREMY DEAN PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1486 ELECTRIC AVE, SUITE #103, BELLINGHAM, WA 98229-2410
(360) 671-5644
Mailing address
2810 W INDIANA ST, #1, BELLINGHAM, WA 98225-1509
(360) 224-8845
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00013632
WA
Other
Enumeration date
09/17/2008
Last updated
09/17/2008
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