Portela, Dustin Ray
Portela, Dustin Ray is an sole proprietor health care provider with primary practice located at 6051 N Eagle Rd , Boise ID 83713-0997. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Portela, Dustin Ray can be contacted via phone (208) 519-4333.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 5101020649 | Michigan |
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | O-1052 | Idaho |
Profile Details
NPI number | 1588002547 |
---|---|
LBN Legal business name | Portela, Dustin Ray |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 11th, 2013 |
Last updated | Nov 27th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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