Individual
MARY GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7040 PUGET BEACH RD NE, OLYMPIA, WA 98516-9158
(360) 456-6971
Mailing address
7040 PUGET BEACH RD NE, OLYMPIA, WA 98516-9158
(360) 456-6971
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD 00024037
WA
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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