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1114709144
JACK PHILIP PORTORSNOK
TACOMA, WA
NPI
1114709144
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: WA cb61440913)
Enumeration Date
2023-10-16
Last Update Date
2023-10-16
Business Address
JACK PHILIP PORTORSNOK
3680 S CEDAR ST
TACOMA, WA 98409-5728
Phone number: 206-313-8840
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Mailing Address
JACK PHILIP PORTORSNOK
5320 204TH STREET CT E
SPANAWAY, WA 98387-5787
Phone number: 253-361-5055
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