Provider Demographics
NPI:1013472919
Name:POTTER, AFTON POWER (PNP)
Entity Type:Individual
Prefix:
First Name:AFTON
Middle Name:POWER
Last Name:POTTER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:AFTON
Other - Middle Name:
Other - Last Name:POWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-7725
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-418-5188
Practice Address - Fax:503-494-4518
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202008542NP-PP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care