Individual
COLLEEN FRIDL GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
3303 SE DIVISION ST, PORTLAND, OR 97202-1456
(503) 730-9073
Mailing address
3735 SE 27TH AVE, PORTLAND, OR 97202-3005
(503) 730-9073
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01136
OR
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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