Healthcare Provider Details

I. General information

NPI: 1598657702
Provider Name (Legal Business Name): QUINTIN PORTERFIELD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3017 E FRANCIS AVE # 101
SPOKANE WA
99208-2435
US

IV. Provider business mailing address

5002 N SIPPLE RD
MILLWOOD WA
99212-1718
US

V. Phone/Fax

Practice location:
  • Phone: 509-467-7991
  • Fax:
Mailing address:
  • Phone: 509-699-3468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.70015627
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: