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Individual
MRS. CAROL GRAY POTTER
Active
Individual
MRS. CAROL GRAY POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, BCG, CAPS
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
1963
WA
225XG0600X
Gerontology Occupational Therapist
Primary
6281
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153392
LABOR & INDUSTRIES
WA
01
—
0373PO
REGENCE BS
WA
05
—
7682305
—
WA
Enumeration date
05/24/2005
Last updated
08/13/2024
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