Provider Demographics
NPI:1386334597
Name:GELSTIN, LAUREN R
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:R
Last Name:GELSTIN
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 1:1016 N SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2059
Mailing Address - Country:US
Mailing Address - Phone:509-326-1651
Mailing Address - Fax:509-326-1658
Practice Address - Street 1:1016 N SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2059
Practice Address - Country:US
Practice Address - Phone:509-326-1651
Practice Address - Fax:509-326-1658
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI61433255235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist