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Individual

MS. HOLLY MARIE GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
310 HADLOCK BAY RD, PORT HADLOCK, WA 98339-9721
(360) 379-5515
Mailing address
1020 MILO ST, PORT TOWNSEND, WA 98368-4035
(360) 301-0183

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60022015
WA

Other

Enumeration date
11/09/2008
Last updated
11/09/2008
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