Individual
EDWIN CHARLES GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC ND LAC
Contact information
Practice address
45 N HOLLADAY DR, SEASIDE, OR 97138
(503) 738-7343
(503) 738-9946
Mailing address
45 N HOLLADAY DR, SEASIDE, OR 97138
(503) 738-7343
(503) 738-9946
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
272219
OR
171100000X
Acupuncturist
AC00733
OR
175F00000X
Naturopath
1078
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076724
—
OR
05
—
213146
—
OR
01
—
862925001
REGENCE BLUE CROSS
OR
01
—
862925003
REGENCE BLUE CROSS
OR
01
—
862925004
REGENCE BLUE CROSS
OR
Enumeration date
03/08/2007
Last updated
11/03/2011
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