NPI age
4 years
Enumerated 2021-12-10
● Active
Type 1 · Individual
Lance Wesley Port, PA-C
Port is 1 of 1 physician assistant providers in Salmon and 1 of 387 in Idaho.
Primary specialty
Physician Assistant
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2021-12-10
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 387 active physician assistant providers in Idaho.
NPI age
4 years
↓ 11 yr below median (15 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
0
30% of peers hold subspecialties
NPI lifetime · 2021 → 2026
2021-12Enumerated in NPPES
2021
2026
Where they practice
Practice location
103 S Daisy St
Salmon, ID 83467
Mailing address
13613 N Manning Ln
Pocatello, ID 832025173
Specialties
-
Physician Assistant PrimaryDefinition to come...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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