Individual
JUSTIN GIFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60324055
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114222189
—
WA
Enumeration date
01/21/2011
Last updated
09/30/2019
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