Individual
CHRIS GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7205 265TH ST NW, STANWOOD, WA 98292-6221
(360) 629-1100
Mailing address
3901 HOYT AVE, EVERETT, WA 98201-4918
(360) 629-1100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA100000400
WA
Other
Enumeration date
11/06/2006
Last updated
02/08/2011
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