Provider Demographics
NPI:1962258236
Name:GILMAN, ROSE
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:GILMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:DEBARGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-0272
Mailing Address - Country:US
Mailing Address - Phone:509-418-5555
Mailing Address - Fax:
Practice Address - Street 1:16114 E INDIANA AVE STE 210
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1874
Practice Address - Country:US
Practice Address - Phone:509-418-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health