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Individual

W MARK POTAMPA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11919 NE 128TH ST, SUITE A, KIRKLAND, WA 98034-7204
(425) 821-6655
(425) 821-8836
Mailing address
1101 MADISON ST, SUITE 600, SEATTLE, WA 98104-1306
(206) 215-2004
(206) 215-2055

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00023322
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0071123
LABOR & INDUSTRIES
WA
01
180021811
RAILROAD MEDICARE
05
8307290
WA
01
PO3997
REGENCE HEALTHCARE
Enumeration date
12/22/2005
Last updated
08/21/2008
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