Individual
SHIMEA NICOLE POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E FOURTH PLAIN BLVD BLDG 17, VANCOUVER, WA 98661-3717
(360) 397-8246
(360) 397-8250
Mailing address
7311 NE 142ND AVE, VANCOUVER, WA 98682-5020
(360) 784-0912
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CG61265548
WA
Other
Enumeration date
01/24/2018
Last updated
01/21/2022
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