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1013055342
WANDA T GUSTAFSON
TACOMA, WA
NPI
1013055342
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: WA ph00011127)
Enumeration Date
2007-02-01
Last Update Date
2007-07-08
Business Address
-- WANDA T GUSTAFSON
9505 S STEELE ST
TACOMA, WA 98444-1858
Phone number: 253-597-6800
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Mailing Address
-- WANDA T GUSTAFSON
PO BOX 34584
SEATTLE, WA 98124-1584
Phone number: 509-241-7349
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