IAN GUSTAFSON

PORTLAND, OR
NPI1033539408
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
Additional Taxonomies101YS0200X Counselor, School
(Licence: OR  555528)
Enumeration Date2014-04-23
Last Update Date2025-08-21
Business Address
IAN GUSTAFSON
707 NE COUCH ST
PORTLAND, OR 97232-2922
Phone number: 503-542-4603
Mailing Address
IAN GUSTAFSON
707 NE COUCH ST
PORTLAND, OR 97232-2922
Phone number: 503-542-4603