Healthcare Provider Details

I. General information

NPI: 1871921114
Provider Name (Legal Business Name): NATALIE GUSTAFSON M.S., LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2013
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 R AVE
ANACORTES WA
98221-2276
US

IV. Provider business mailing address

1601 R AVE
ANACORTES WA
98221-2276
US

V. Phone/Fax

Practice location:
  • Phone: 360-299-4038
  • Fax:
Mailing address:
  • Phone: 360-391-4855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF00002509
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: