Individual
JOHN ROBERT POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Contact information
Practice address
551 21ST AVE, LONGVIEW, WA 98632-1303
(360) 270-8109
Mailing address
551 21ST AVE, LONGVIEW, WA 98632-1303
(360) 270-8109
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60741004
WA
Other
Enumeration date
05/04/2018
Last updated
08/11/2020
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