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Contact Information

JENNIFER M GIBSON, MD
3449 N ANCHOR ST STE 300A
PORTLAND, OR97217-7679
 Phone: 503-283-0013
 Fax: 503-283-0785
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for JENNIFER M GIBSON · (Female)

NPI Number 1144299900
Status Active
Credentials MD
Entity Individual
Enumeration date 03/15/2006
Last updated 03/27/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • IA License # 37913
  • IA Medicaid 1144299900
  • IA Other 1144299900 MN MEDICAID
  • IA Other 1144299900 WELLMARK
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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