Gustafson, Cheryl Janene

Gustafson, Cheryl Janene is an individual health care provider with primary practice located at 3216 Ne 45Th Pl Ste 101 , Seattle WA 98105-4028. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is her primary health care specialty. Gustafson, Cheryl Janene can be contacted via phone (206) 525-1168.

Contact Information

Primary practice address
3216 Ne 45Th Pl Ste 101 Seattle WA 98105-4028
Fax: (206) 525-1169
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 01075298A Indiana
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X MD60757392 Washington

Profile Details

NPI number 1083840565
LBN Legal business name Gustafson, Cheryl Janene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2009
Last updated Jan 29th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083840565 NPPES
Washington MEDICAID 2084320

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