Provider Demographics
NPI:1225837776
Name:ULATOWSKI, PORSCHA SHAREE
Entity type:Individual
Prefix:
First Name:PORSCHA
Middle Name:SHAREE
Last Name:ULATOWSKI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:PORSCHA
Other - Middle Name:SHAREE
Other - Last Name:ULATOWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PORSCHA ULATOWSKI
Mailing Address - Street 1:7258 LINARIA RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3231
Mailing Address - Country:US
Mailing Address - Phone:248-722-1751
Mailing Address - Fax:
Practice Address - Street 1:7258 LINARIA RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3231
Practice Address - Country:US
Practice Address - Phone:248-722-1751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath