Provider Demographics
NPI:1295189207
Name:BIBBY, MARGARET (LMT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BIBBY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:MAUGHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:19142 MOLALLA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-7166
Mailing Address - Country:US
Mailing Address - Phone:971-203-8725
Mailing Address - Fax:
Practice Address - Street 1:19142 MOLALLA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-7166
Practice Address - Country:US
Practice Address - Phone:971-203-8725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19996174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist