Basic Information
| Provider Information | |||||||||
| NPI: | 1255814661 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GURTNER | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | ROSEANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6503 E MABURY AVE | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928672436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149137670 | ||||||||
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| Practice Location | |||||||||
| Address1: | 910 W BOONE AVE | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992015029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093257232 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2018 | ||||||||
| LastUpdateDate: | 09/11/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 60706943 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.