Individual
REESE ERVIN GIBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
847 NE 19TH AVE STE 100, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
A14518
OR
372600000X
Adult Companion
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2018
Last updated
11/21/2023
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