Healthcare Provider Details

I. General information

NPI: 1679605828
Provider Name (Legal Business Name): GIBBS NATURAL HEALING CENTRE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 N HOLLADAY DR
SEASIDE OR
97138
US

IV. Provider business mailing address

45 N HOLLADAY DR
SEASIDE OR
97138
US

V. Phone/Fax

Practice location:
  • Phone: 503-738-7343
  • Fax: 503-738-9946
Mailing address:
  • Phone: 503-738-7343
  • Fax: 503-738-9946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: MARY ANN GIBBS
Title or Position: SECRETARY
Credential: DC
Phone: 503-738-7343