Active NPI
Carrie Elizabeth Potter
- Counselor
- Oak Harbor, WA
National Provider Identifier
1063989853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- MC60956104
- Practice address
- 32650 Sr 20
Suite C206
Oak Harbor, WA 98277 - Phone
- (425) 212-4200
- NPI assigned
- Oct 30, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Counselor | 101Y00000X | MC60956104 | WA | Primary |
Addresses
Primary practice location
32650 Sr 20
Suite C206
Oak Harbor, WA 98277
Mailing address
32650 Sr 20
Suite C206
Oak Harbor, WA 98277
Phone (425) 736-8375
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 10, 2024 through Sep 10, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC60956104 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1063989853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32650 SR 20",
"address_2": "SUITE C206",
"city": "OAK HARBOR",
"state": "WA",
"postal_code": "98277",
"telephone_number": "425-736-8375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32650 SR 20",
"address_2": "SUITE C206",
"city": "OAK HARBOR",
"state": "WA",
"postal_code": "98277",
"telephone_number": "425-212-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "CARRIE",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-30",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "MC60956104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.