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1164185021
TAMMIE L POTTER
ROSEBURG, OR
NPI
1164185021
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 200230108LPN)
Enumeration Date
2021-10-18
Last Update Date
2021-10-18
Business Address
TAMMIE L POTTER
3099 NE DIAMOND LAKE BLVD
ROSEBURG, OR 97470-3655
Phone number: 541-673-3469
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Mailing Address
TAMMIE L POTTER
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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