Organization
MOUNTAINSIDE PSYCHIATRIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN HUGHES POTTER MN, ARNP (OWNER/OPERATOR)
(253) 460-9414
Entity
Organization
Contact information
Practice address
10209 BRIDGEPORT WAY SW, SUITE D 10, LAKEWOOD, WA 98499-2320
(253) 460-9414
(253) 460-0999
Mailing address
10209 BRIDGEPORT WAY SW, SUITE D 10, LAKEWOOD, WA 98499-2326
(253) 460-9414
(253) 460-0999
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
08/12/2006
Last updated
08/25/2008
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