Justin Terry Porter

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P160857473 Issued in WA

Practice address

380 Chase Ave
Walla Walla, WA 99362-2924

Phone

(509) 897-8600

NPI assigned

Jul 25, 2024

Last updated

Jul 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thrive Integrative Health & Physical Therapy LLC

  • Physical Therapist
  • Touchet, WA
  • NPI 1053987917
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1396573820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2994 BARNEY RD",
            "city": "TOUCHET",
            "state": "WA",
            "postal_code": "993609681",
            "telephone_number": "509-540-9137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CHASE AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622924",
            "telephone_number": "509-897-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JUSTIN",
        "middle_name": "TERRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160857473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Planned Parenthood of Greater Washington and Northern Idaho (Ppgwni)
• Dennis Rocke Poffenroth, OD
• Josquin J Poirot, DPT
• Rose Amara Pokrifchak, MA, LMHC
• Janette Polley, RN
• Alecksana Potter
• Erin Pratt
• Michael Darwin Preas, LCSW
• Joanne Price, M.A.
• Michael Priddy, MD

• Physical Therapy Assistant in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.