Provider Demographics
NPI:1417097585
Name:BRUCE A PORTER MD PS
Entity Type:Organization
Organization Name:BRUCE A PORTER MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACR
Authorized Official - Phone:206-329-6767
Mailing Address - Street 1:1001 BOYLSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1389
Mailing Address - Country:US
Mailing Address - Phone:206-329-6767
Mailing Address - Fax:206-323-6989
Practice Address - Street 1:1001 BOYLSTON AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1389
Practice Address - Country:US
Practice Address - Phone:206-329-6767
Practice Address - Fax:206-323-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty