Provider Demographics
NPI:1922604453
Name:GERING, PORNPAN (MA)
Entity Type:Individual
Prefix:
First Name:PORNPAN
Middle Name:
Last Name:GERING
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 W HELENS LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-7138
Mailing Address - Country:US
Mailing Address - Phone:425-951-9082
Mailing Address - Fax:
Practice Address - Street 1:2812 W HELENS LN
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-7138
Practice Address - Country:US
Practice Address - Phone:425-951-9082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health