Charles Stuart Potrykus, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

8514 Holly LN
Edmonds, WA 98026-8635

Phone

(206) 313-9546

NPI assigned

Jun 13, 2007

Last updated

Jan 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacmed Clinics

  dba Pacific Medical Centers

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1013061217
  Medicare reassignment NPD
• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1720023641
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1346444395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8514 HOLLY LN",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268635",
            "telephone_number": "206-313-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8514 HOLLY LN",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268635",
            "telephone_number": "206-313-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTRYKUS",
        "first_name": "CHARLES",
        "middle_name": "STUART",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aliese Lynn Poole
• Hannah Pope
• Claire Popke
• Alyssa Ryan Porcaro, LMT
• Danielle C Porter, LMHCA, SUDPT
• Teysha Potter
• Anastasia Powell, MPH, RDN
• Ray Power
• Joni E Powers, DNP, ARNP
• Douglas B Prather, RDH

• Mental Health Counselor in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.