Individual
DR. KENDRA JO PORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1102 A ST UNIT 1536, TACOMA, WA 98401-1210
(253) 274-1668
(253) 274-1685
Mailing address
1102 A ST UNIT 1536, TACOMA, WA 98401-1210
(253) 274-1668
(253) 274-1685
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
60389023
WA
207L00000X
Anesthesiology Physician
Primary
Q9006
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359428501
—
TX
05
—
359428502
—
TX
01
—
8GC534
BCBS
TX
01
—
P01712915
RR
TX
Enumeration date
05/07/2009
Last updated
10/27/2020
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