Individual
BENJAMYN LAWRENCE POTVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SF-IDC, CPHT, NREMT
Contact information
Practice address
2000 W MARINE VIEW DR BLDG 2108, EVERETT, WA 98207-0001
(907) 942-2460
Mailing address
10652 HORIZON LANE EAST SE, PORT ORCHARD, WA 98367-9605
(907) 942-2460
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
E3223966
CA
1710I1002X
Independent Duty Corpsman
Primary
—
CA
183700000X
Pharmacy Technician
30045107
TX
Other
Enumeration date
11/14/2020
Last updated
06/10/2025
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