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1811007198
KIMBERLY GUSTAFSON
PORTLAND, OR
NPI
1811007198
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
Enumeration Date
2006-08-30
Last Update Date
2007-07-08
Business Address
Ms. KIMBERLY GUSTAFSON RD
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239-2964
Phone number: 503-220-8262
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Mailing Address
Ms. KIMBERLY GUSTAFSON RD
3220 SW PRIMROSE ST
PORTLAND, OR 97219-5315
Phone number: 503-220-8262
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