Julie Allina Gustafson, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD00017560 Issued in WA

Practice address

104 27TH Ave SE
Puyallup, WA 98374-1145

Phone

(253) 848-0368

Fax

(253) 435-4937

NPI assigned

Jan 30, 2007

Last updated

May 21, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ear,Nose,Throat & Allergy Associates PS

  • Specialist
  • Puyallup, WA
  • NPI 1154488732
  NPD (past)
• Proliance Surgeons Inc PS

  dba Proliance Hillside Medical Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Puyallup, WA
  • NPI 1780610220
  NPD (past)
• Proliance Surgeons, Inc., P.S.

  dba Proliance Ear Nose Throat and Allergy Associates

  • Otolaryngology Physician
  • Puyallup, WA
  • NPI 1407223985
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1508902081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 27TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741145",
            "telephone_number": "253-848-0368",
            "fax_number": "253-435-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 27TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741145",
            "telephone_number": "253-848-0368",
            "fax_number": "253-435-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "JULIE",
        "middle_name": "ALLINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00017560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7078017",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kailee Ann Gunderman
• Amy M Gunderson, LMP
• Ariana Gunter
• Neha Gupta, DDS
• Eugenia D Guray, MD
• Iris Guzman, MSW
• H.S. Walia DDS Fagd & Kunal Walia DDS PS (Dr. Happy Smiles)
• Leonard M Haan
• Fikru Habte
• Abigail G Haegele

• Otolaryngology Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Otolaryngology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.