Individual
DR. MARK BLAINE POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1112 6TH AVE STE 200, TACOMA, WA 98405
(253) 272-8664
(253) 627-7880
Mailing address
104 GRANBURG CIR, SAN ANTONIO, TX 78218-3033
(210) 826-1308
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
02002013A
IN
207RG0100X
Gastroenterology Physician
Primary
OP60322613
WA
Other
Enumeration date
01/30/2006
Last updated
05/23/2018
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