MEDICARE: SCOT POTTER

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
1	101YS0200X	School Counselor	560408	OR

General Provider Information

NPI Number	:	1811825953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOT POTTER

Provider Business Mailing Address
First Line	:	500 N 5TH ST
Second Line	:
City	:	LEBANON
State	:	OR
Zip	:	97355-2873
Country	:	US
Telephone Number	:	541-451-8487
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 N 5TH ST
Second Line	:
City	:	LEBANON
State	:	OR
Zip	:	97355-2873
Country	:	US
Telephone Number	:	541-451-8487
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/20/2026

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Directions to “ SCOT POTTER ” Practice Location

Language	Start Address	Practice Location

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