Individual
ADRIENNE M GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC
Contact information
Practice address
323 NE 80TH AVE, PORTLAND, OR 97213-7017
(480) 296-6412
Mailing address
14025 SW FARMINGTON RD # 160, BEAVERTON, OR 97005-2512
(503) 258-4498
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C3446
OR
101YP2500X
Professional Counselor
LPC-12876
AZ
Other
Enumeration date
02/22/2008
Last updated
11/19/2014
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