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Individual

MS. LISA CAMILLE GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN BSN

Contact information

Practice address
722 NE 162ND AVE, ALBERTINA KERR CENTER YOUTH & FAMILY SERVICES, PORTLAND, OR 97024
(503) 255-4205
Mailing address
722 NE 162ND AVE, ALBERTINA KERR CENTER YOUTH & FAMILY SERVICES, PORTLAND, OR 97024
(503) 255-4205

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
OR

Other

Enumeration date
04/09/2008
Last updated
04/09/2008
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