Individual
MARYIKA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1700 NE EVERETT ST, CAMAS, WA 98607-1224
(360) 216-1536
Mailing address
1700 NE EVERETT ST, CAMAS, WA 98607-1224
(360) 216-1536
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
20139195NP
OR
363LF0000X
Family Nurse Practitioner
Primary
AP60401486
WA
Other
Enumeration date
01/30/2014
Last updated
08/29/2022
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