Individual
DR. BRENT C POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 W COLLEGE AVE, SPOKANE, WA 99201-2010
(509) 324-1420
Mailing address
PO BOX 528, BETHEL, AK 99559-0528
(970) 543-6100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60721362
WA
101YM0800X
Mental Health Counselor
LH00007704
WA
101YP2500X
Professional Counselor
LH0007704
WA
103TC0700X
Clinical Psychologist
2012832
CA
103TC0700X
Clinical Psychologist
LH00007704
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
08/17/2006
Last updated
06/24/2021
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