Samantha Madison Gustafson, PAC
NPI #1376262246 in Newport, Washington
Provider Information
- NPI Number
- 1376262246
- Entity Type
- Individual
- Name
- Samantha Madison Gustafson, PAC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PAC
- Enumeration Date
- Aug 24, 2022
- Last Updated
- Jun 10, 2024
Practice Location
- Address
- 714 W PINE ST BLDG C
- City
- Newport
- State
- Washington
- ZIP Code
- 99156-9046
- Phone
- (509) 447-3139
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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