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

Primary practice address
6051 N Eagle Rd Boise ID 83713-0997
Phone: (208) 519-4333
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 5 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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