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General NPI Number Information
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NPI Number | 1467408815
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Entity Type | Individual
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Provider Name | WILLIAM THOMAS GIBSON NP, PHD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1125 SE WASHINGTON ST.
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City | PULLMAN
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State | WA
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Zip | 99111
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Country | US
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Telephone | 509-335-3575
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Fax | 509-336-7389
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Provider Business Mailing Address
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Address Line | 1125 SE WASHINGTON ST.
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City | PULLMAN
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State | WA
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Zip | 99111
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Country | US
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Telephone | 509-335-3575
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Fax | 509-336-7389
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | AP30005329
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY12342713
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PY00002713
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNS-11A
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP30005329
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License Number State | WA
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