Individual
DYLAN GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22518 S PARROTT CREEK RD., OREGON CITY, OR 97045-9704
(503) 266-3050
Mailing address
22518 S PARROTT CREEK RD., OREGON CITY, OR 97045
(503) 266-3050
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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