Provider Demographics
NPI:1104962471
Name:THUROW, GAELEN LAUREL
Entity type:Individual
Prefix:MS
First Name:GAELEN
Middle Name:LAUREL
Last Name:THUROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16820 SE POWELL BLVD
Mailing Address - Street 2:APT 201
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-1786
Mailing Address - Country:US
Mailing Address - Phone:503-679-3330
Mailing Address - Fax:
Practice Address - Street 1:3587 HEATHROW WAY
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4004
Practice Address - Country:US
Practice Address - Phone:541-858-8170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health