| Doctor Name: | DR. GARY ROBERT LAUSTSEN |
| NPI Number: | 1033291596 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP, PHD |
| License Number: | 200650119NP FNP-PP |
| Business Practice Address: | 1 University Blvd La Grande, OR - 978502807 |
| Business Phone Number: | 5419623132 |
| Business Fax Number: | |
| Mailing Address: | 1 University Blvd, LA GRANDE |
| State: | OR |
| Postal Code: | 978502807 |
| Phone Number: | 5419623132 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2006 |
| NPI Last Update Date: | 03/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 200650119NP FNP-PP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |