NPI 1083727507

Jean-Luc Louis Gustin, PA

Practitioner Medical Physician Assistant Beaverton, OR

Practice location

Address: 4855 SW Western Ave, Beaverton, OR 97005-3460
Phone: (503) 643-7565
Mailing address: 14481 S Buckner Creek Rd, Mulino, OR 97042-9626

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence PA00309 (OR)

Other Physician Assistant providers in Oregon →

Registry record

NPI: 1083727507
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.