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Individual

MARTHA B GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3223 1ST AVE S, SUITE C, SEATTLE, WA 98134-1850
(206) 624-3651
(206) 624-2391
Mailing address
3223 1ST AVE S, SUITE C, SEATTLE, WA 98134-1850
(206) 624-3651
(206) 624-2391

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10002796
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202528
LABOR AND INDUSTRIES
WA
Enumeration date
02/09/2007
Last updated
07/08/2007
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