Individual
DR. GARARD MELVIN GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
101 MILTON WAY, MILTON, WA 98354-8800
(253) 922-0333
(253) 922-7322
Mailing address
101 MILTON WAY, MILTON, WA 98354-8800
(253) 922-0333
(253) 922-7322
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00000938
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2343002
—
WA
Enumeration date
08/22/2005
Last updated
05/08/2008
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