Individual
H THERESA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
693 HALLERWOOD WAY, COLVILLE, WA 99114
(509) 684-9293
Mailing address
693 HALLERWOOD WAY, COLVILLE, WA 99114
(509) 684-9293
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001255TX
WA
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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