Individual provider · Type 1 NPI

Samantha Madison Gustafson, PAC

Medical Physician Assistant · Newport, WA

NPI number 1376262246 Active

Practice location

714 W Pine St Bldg C
Newport, WA 99156-9046

Fax (509) 897-8597

Mailing address

714 W Pine St
Newport, WA 99156-9046

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA61488948 (WA)

Medical Physician Assistant: Definition to come...

9 other providers at this address

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About NPI 1376262246

Samantha Madison Gustafson, PAC's National Provider Identifier is 1376262246, issued on Aug 24, 2022. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Newport, WA. The record was last updated on Jun 10, 2024.