Individual
CARLY GUSTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 NE 109TH AVE, VANCOUVER, WA 98682-7749
(360) 695-1014
(360) 750-1374
Mailing address
3200 NE 109TH AVE, VANCOUVER, WA 98682-7749
(360) 695-1014
(360) 750-1374
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61179700
WA
Other
Enumeration date
08/03/2021
Last updated
04/26/2023
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