Individual
ALLEN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23 NW GREENWOOD AVE, BEND, OR 97703-2078
(541) 383-4293
Mailing address
19394 SW LAURELHURST WAY, BEND, OR 97702-3192
(541) 280-2990
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00-07-13
OR
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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