Provider Demographics
NPI:1548140320
Name:LIGHTEL, CRYSTALENA ROSA F
Entity type:Individual
Prefix:
First Name:CRYSTALENA
Middle Name:ROSA F
Last Name:LIGHTEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7817 N ASH LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-5068
Mailing Address - Country:US
Mailing Address - Phone:509-557-0070
Mailing Address - Fax:
Practice Address - Street 1:8601 N DIVISION ST STE G
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-5915
Practice Address - Country:US
Practice Address - Phone:509-557-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health