Potter, Brent C

Potter, Brent C is an individual health care provider with primary practice located at 1101 W College Ave , Spokane WA 99201-2010. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Potter, Brent C can be contacted via phone (509) 324-1420.

Contact Information

Primary practice address
1101 W College Ave Spokane WA 99201-2010
Phone: (509) 324-1420
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LH00007704 Washington
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2012832 California
Behavioral Health & Social Service Providers / Professional 101YP2500X LH0007704 Washington
Behavioral Health & Social Service Providers / Clinical 103TC0700X LH00007704 Washington
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CP60721362 Washington

Profile Details

NPI number 1174636500
LBN Legal business name Potter, Brent C
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Jun 24th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174636500 NPPES
Alaska MEDICAID 1020986

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