Provider Demographics
NPI:1073657292
Name:GIBBS, CHRISTINE B (LM, RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:B
Last Name:GIBBS
Suffix:
Gender:F
Credentials:LM, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 CORNWALL AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3415
Mailing Address - Country:US
Mailing Address - Phone:360-752-2229
Mailing Address - Fax:360-752-2228
Practice Address - Street 1:2430 CORNWALL AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3415
Practice Address - Country:US
Practice Address - Phone:360-752-2229
Practice Address - Fax:360-752-2228
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN144073163W00000X
WAMW263176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8396871Medicaid