Individual
GUS WHITTINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 SUNSET DR, LA GRANDE, OR 97850-1387
(541) 963-1513
Mailing address
900 SUNSET DR, LA GRANDE, OR 97850-1387
(541) 963-1513
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1218225
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/08/2022
Last updated
09/23/2024
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