Provider Demographics
NPI:1770232571
Name:PORTER, CARRIE LORRAINE (OTD, OTR/L, CLT)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LORRAINE
Last Name:PORTER
Suffix:
Gender:F
Credentials:OTD, OTR/L, CLT
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:LORRAINE
Other - Last Name:HULBURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:3074 MOUNTAIN VIEW DR STE 184&187
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3144
Mailing Address - Country:US
Mailing Address - Phone:907-531-1888
Mailing Address - Fax:915-531-1889
Practice Address - Street 1:3074 MOUNTAIN VIEW DR STE 184&187
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3144
Practice Address - Country:US
Practice Address - Phone:907-531-1888
Practice Address - Fax:915-531-1889
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK192444225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist