Matthew Potter
Behavior Technician in Vancouver, WA. Individual provider (NPI-1).
NPI number1962390617
StatusActive
Last updated in NPPESJun 24, 2025
Details
- NPI
- 1962390617
- Entity type
- Individual (NPI-1)
- Name
- Matthew Potter
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 24, 2025
- Certification date
- Jun 24, 2025
- Last updated
- Jun 24, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
720 Se 160th Ave # 154Vancouver, WA 98684-8911
Phone 833-599-2560
Mailing address
850 Towbin AveLakewood, NJ 08701-5928
Phone 833-599-2560
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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