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Individual

MS. AMY ISLER GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.C.

Contact information

Practice address
11740 SW 68TH PKWY STE 200, TIGARD, OR 97223-9058
(541) 729-0551
Mailing address
5441 S MACADAM AVE STE A, PORTLAND, OR 97239-6106

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C7138
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
36702
OREGON STATE LICENSURE (LICENSED PROFESSIONAL COUNSELOR)
OR
Enumeration date
04/26/2011
Last updated
04/09/2025
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