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1033539408
IAN GUSTAFSON
PORTLAND, OR
NPI
1033539408
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2014-04-23
Last Update Date
2014-04-23
Business Address
-- IAN GUSTAFSON
707 NE COUCH ST
PORTLAND, OR 97232-2922
Phone number: 503-542-4603
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Mailing Address
-- IAN GUSTAFSON
707 NE COUCH ST
PORTLAND, OR 97232-2922
Phone number: 503-542-4603
Copy
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