Provider Demographics
NPI:1811162944
Name:PORTER-VILARET, MICHELE MARIE (RPH)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:MARIE
Last Name:PORTER-VILARET
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:MICHELE
Other - Middle Name:VILARET
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:R,PH
Mailing Address - Street 1:1399 NEW YORK AVE NW STE 725
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-4764
Mailing Address - Country:US
Mailing Address - Phone:202-942-7223
Mailing Address - Fax:202-393-1589
Practice Address - Street 1:1399 NEW YORK AVE NW STE 725
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4764
Practice Address - Country:US
Practice Address - Phone:202-942-7223
Practice Address - Fax:202-393-1589
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS00018507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist