Provider Demographics
NPI:1073781555
Name:CRANSTON-GOHSMAN, CELENE A (DC)
Entity Type:Individual
Prefix:DR
First Name:CELENE
Middle Name:A
Last Name:CRANSTON-GOHSMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 LOWER PEOH POINT RD
Mailing Address - Street 2:
Mailing Address - City:CLE ELUM
Mailing Address - State:WA
Mailing Address - Zip Code:98922-8474
Mailing Address - Country:US
Mailing Address - Phone:509-674-2801
Mailing Address - Fax:509-674-2942
Practice Address - Street 1:2131 LOWER PEOH POINT RD
Practice Address - Street 2:
Practice Address - City:CLE ELUM
Practice Address - State:WA
Practice Address - Zip Code:98922-8474
Practice Address - Country:US
Practice Address - Phone:509-674-2801
Practice Address - Fax:509-674-2942
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB-16417Medicare UPIN
WAAB-16417Medicare PIN