Provider Demographics
NPI:1629881081
Name:GASTON, KATELYN LEE (RN, ADN)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:LEE
Last Name:GASTON
Suffix:
Gender:F
Credentials:RN, ADN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12310 E MIRABEAU PKWY STE 500
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-2259
Mailing Address - Country:US
Mailing Address - Phone:509-473-4900
Mailing Address - Fax:509-473-4953
Practice Address - Street 1:12310 E MIRABEAU PKWY STE 500
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2259
Practice Address - Country:US
Practice Address - Phone:509-473-4900
Practice Address - Fax:509-473-4953
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60724732163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health