Healthcare Provider Details

I. General information

NPI: 1750298071
Provider Name (Legal Business Name): IVORY MARIE GYPSY GUNTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3812 N MONROE ST
SPOKANE WA
99205-2852
US

IV. Provider business mailing address

3812 N MONROE ST
SPOKANE WA
99205-2852
US

V. Phone/Fax

Practice location:
  • Phone: 509-327-7078
  • Fax:
Mailing address:
  • Phone: 509-327-7078
  • Fax: 509-327-3404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number70119072
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: