Individual
NANCY MARIE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3727 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-1112
(503) 775-4931
(503) 788-7285
Mailing address
3727 NE MARTIN LUTHER KING JR BLVD, ATTN: CREDENTIALING, PORTLAND, OR 97212-1112
(503) 775-4931
(503) 788-7285
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
099007140N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023055
—
OR
05
—
9655887
—
WA
Enumeration date
07/19/2006
Last updated
11/15/2011
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