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NPI Code Detail

MEDICARE: BARBARA POTTS

MEDICARE: BARBARA POTTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1518354430
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA POTTS
Provider Business Mailing Address
First Line : 3587 HEATHROW WAY
Second Line :
City : MEDFORD
State : OR
Zip : 97504-4004
Country : US
Telephone Number : 541-778-6518
Fax Number :
Provider Business Practice Location Address
First Line : 13850 SE AUTUMN RIDGE TER
Second Line :
City : MILWAUKIE
State : OR
Zip : 97267-2150
Country : US
Telephone Number : 503-974-9250
Fax Number : 503-974-9586
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2015
Last Update Date : 02/18/2016

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Directions to “ BARBARA POTTS ” Practice Location

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