Individual
RON L PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
10503 W THUNDERBIRD BLVD, SUN CITY, AZ 85351-3022
(623) 888-3370
Mailing address
10503 W THUNDERBIRD BLVD STE 200, SUN CITY, AZ 85351-2746
(623) 888-3370
(480) 795-6158
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT00002084
WA
225X00000X
Occupational Therapist
Primary
OTH-006446
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039584
LABOR AND INDUSTRIES#
WA
01
—
2944PO
BLUE SHIELD #
WA
05
—
8428575
—
WA
01
—
US7329675
AETNA SPECIALIST PIN
WA
Enumeration date
01/18/2007
Last updated
01/27/2025
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