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Deactivated NPI 1639249592 Deactivated / Inactive NPI Male Practitioner

Jack C Potter , RPH

Pharmacist • Othello, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jack Potter has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 08, 2006
NPI Deactivation Date October 22, 2018
Total Practice Duration ~12 Years of Practice (2006 – 2018)

Professional Overview & Biography Verified Profile Summary

Jack Potter, RPH was a registered Pharmacist practicing in Othello, WA. Throughout an active medical career spanning 12 years, Jack Potter provided care at the practice location at 140 E MAIN ST until profile deactivation on 2018-10-22.

Practice Location & Contact Primary Location

Practice Address

140 E Main St

Othello, WA 99344

Telephone 5094885256
Fax 5094889939
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Othello, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 7.0 Yrs
Regional Practice Density
15 Specialists

Practicing in Othello, WA (7956 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License WA PH00006488

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Laura Ely

Nurse Practitioner - Family

NPI 1003263872

Doctor of Dental Surgery

Mikayla Alonzo , RDH

Dental Hygienist

NPI 1003593294

Registered Dental Hygienist

Dr. Ji Choi , DDS

Dentist - General Practice

NPI 1023165065

Doctor of Dental Surgery

Dr. Randel Bunch , MD

Family Medicine

NPI 1033296637

Doctor of Medicine (M.D.)

NPI 1033768957

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 22, 2018

Record deactivated on October 22, 2018

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 140 E MAIN ST, OTHELLO, WA 99344 (Tel: 5094885256)

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Updated Business Mailing Address July 08, 2007

Registered at 140 E MAIN ST, OTHELLO, WA 99344 (Tel: 5094885256)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JACK POTTER, RPH

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pharmacist (License #PH00006488 in WA)

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Initial NPI Registration & Enumeration November 08, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639249592
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 08, 2006
Last Update: July 08, 2007
Deactivation Date: October 22, 2018

Mailing Address

140 E Main St

Othello, WA 99344

Phone: 5094885256

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.