Individual ProviderJustin LaportePsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011(503) 494-6176PECOS EnrollmentBased on the most recent information from CMS, provider Justin Laporte is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1841653532Provider TypeIndividualFull NameLaporte, JustinGenderMaleSole ProprietorNoEnumeration Date3/31/2016Last Updated5/26/2022Contact InformationPractice LocationPractice Address3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011Phone(503) 494-6176Fax(503) 494-6152Mailing LocationMailing Address3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseMD198115OregonCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer