Individual
DR. ROBERT D GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3900 KERN WAY, YAKIMA, WA 98902-7803
(509) 966-1356
(509) 966-5101
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3008
(360) 807-7687
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00003294
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023548
—
WA
01
—
410045005
RAIL ROAD MEDICARE
WA
01
—
410045007
RAIL ROAD MEDICARE
ID
01
—
410045008
RAIL ROAD MEDICARE
OR
01
—
410047409
RAIL ROAD MEDICARE
MT
Enumeration date
08/24/2006
Last updated
11/19/2020
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