Individual
MARY ANN GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
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
272517
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076711
—
OR
01
—
862925002
REGENCE BLUE CROSS
OR
Enumeration date
03/08/2007
Last updated
11/03/2011
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