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NPI Code Detail

MEDICARE: PANDY BETH GIBSON

MEDICARE: PANDY BETH GIBSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246RP1900XPhlebotomy TechnicianPC61086725WA
2101YM0800XMental Health Counselor60962947WA

General Provider Information

NPI Number : 1568015337
Entity Type Code : Individual
Provider Name (Legal Business Name) : PANDY BETH GIBSON
Provider Business Mailing Address
First Line : 3285 FERGUSON ST SW
Second Line :
City : TUMWATER
State : WA
Zip : 98512-6143
Country : US
Telephone Number : 360-943-1907
Fax Number : 360-943-1912
Provider Business Practice Location Address
First Line : 3285 FERGUSON ST SW
Second Line :
City : TUMWATER
State : WA
Zip : 98512-6143
Country : US
Telephone Number : 360-252-2989
Fax Number : 360-943-1912
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2019
Last Update Date : 05/17/2023

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Directions to “ PANDY BETH GIBSON ” Practice Location

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