Provider Demographics
NPI:1407854805
Name:GIBSON, KARI LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:LYNN
Last Name:GIBSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 RAINIER ST
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2958
Mailing Address - Country:US
Mailing Address - Phone:360-568-8800
Mailing Address - Fax:
Practice Address - Street 1:811 RAINIER ST
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2958
Practice Address - Country:US
Practice Address - Phone:360-568-8800
Practice Address - Fax:425-487-6818
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AB26284Medicare ID - Type Unspecified
U488247Medicare UPIN