Individual
JEANNA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
431 BROWN RD, ELLENSBURG, WA 98926-8995
(509) 306-0657
Mailing address
2690 SR 903, CLE ELUM, WA 98922-8995
(509) 649-4729
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SP60655423
WA
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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