Individual
GOURI BHAWAN POTHINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1455 BATTERSBY AVE, ENUMCLAW, WA 98022-3634
(360) 802-8800
Mailing address
5000 HOPYARD RD STE 100, PLEASANTON, CA 94588-3146
(925) 924-1600
(925) 924-0506
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.60729650
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
WA
Enumeration date
09/28/2009
Last updated
12/27/2017
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