Healthcare Provider Details

I. General information

NPI: 1689386765
Provider Name (Legal Business Name): BUTLER COLLETTE & PORTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2022
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 DUPORTAIL ST STE 203
RICHLAND WA
99352-6105
US

IV. Provider business mailing address

3200 DUPORTAIL ST STE 203
RICHLAND WA
99352-6105
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-7689
  • Fax: 509-946-7689
Mailing address:
  • Phone: 509-946-7689
  • Fax: 509-946-8312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: EVA M ADAMS
Title or Position: FINANCIAL COORDINATOR
Credential:
Phone: 509-946-7689