Provider Demographics
NPI:1710398623
Name:GUSTAFSON, SAFFRON (MBA, CMF)
Entity Type:Individual
Prefix:
First Name:SAFFRON
Middle Name:
Last Name:GUSTAFSON
Suffix:
Gender:F
Credentials:MBA, CMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 SW BARNES RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6663
Mailing Address - Country:US
Mailing Address - Phone:503-206-4223
Mailing Address - Fax:503-764-9633
Practice Address - Street 1:9555 SW BARNES RD
Practice Address - Street 2:SUITE 215
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6663
Practice Address - Country:US
Practice Address - Phone:503-206-4223
Practice Address - Fax:503-764-9633
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist