Individual
KATHY GIBBENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
9432 SW 164TH AVE, BEAVERTON, OR 97007-9415
(971) 506-6870
(503) 642-9434
Mailing address
PO BOX 2264, BEAVERTON, OR 97075-2264
(971) 506-6870
(503) 642-9434
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
094000296RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341686
PROVIDENCE HEALTH PLANS
OR
Enumeration date
01/05/2007
Last updated
09/20/2008
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