Individual
KATIE GUSTAVSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 S 336TH ST STE 210, FEDERAL WAY, WA 98003-7354
(866) 835-8091
Mailing address
1010 S 336TH ST STE 210, FEDERAL WAY, WA 98003-7354
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60231427
WA
Other
Enumeration date
07/27/2011
Last updated
07/27/2011
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