Individual
STEPHANIE HARPER POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
627 NE EVANS ST, MCMINNVILLE, OR 97128
(503) 434-7523
(503) 434-8597
Mailing address
PO BOX 6149, ALOHA, OR 97007-0149
(503) 359-8501
(503) 434-8597
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200250090
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100376
—
OR
01
—
9644881
WA DSHS PROVIDER
WA
01
—
ANP 0319
WORKER'S COMP
OR
Enumeration date
06/14/2005
Last updated
02/11/2019
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