Potschka, Gretchen Marie
Potschka, Gretchen Marie is an individual health care provider with primary practice located at 1615 Delaware St , Longview WA 98632-2310. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Potschka, Gretchen Marie can be contacted via phone (360) 414-2385.Contact Information
Primary practice address
1615 Delaware St
Longview WA 98632-2310
Phone: (360) 414-2385
Fax: (360) 414-2386
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD00042178 | Washington |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00042178 | Washington |
Profile Details
| NPI number | 1811994718 |
|---|---|
| LBN Legal business name | Potschka, Gretchen Marie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Jan 10th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811994718 | NPPES |
| Other | P00019811 | RR MEDICARE | |
| Other | 171088 | RR MEDICARE | |
| MEDICAID | 8359192 | RR MEDICARE | |
| MEDICAID | 226976 | RR MEDICARE | |
| Other | 8932202 | RR MEDICARE |
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