Individual
MRS. CASSONDRA LYNN GIBEAUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5860 NW HIGHLAND PL, CORVALLIS, OR 97330-9729
(541) 745-5799
Mailing address
2523 FULTON ST SE, ALBANY, OR 97322-5737
(541) 990-5039
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201130082LPN
OR
376K00000X
Nurse's Aide
200412048CNA
OR
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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