Individual
DERICK AARON POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9530
Mailing address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9530
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60630477
WA
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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