Provider Demographics
NPI:1831297936
Name:GIBSON, VALERIE WASHINGTON (PT)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:WASHINGTON
Last Name:GIBSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8230 OLD COURTHOUSE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3853
Mailing Address - Country:US
Mailing Address - Phone:703-749-0223
Mailing Address - Fax:703-749-0225
Practice Address - Street 1:8230 OLD COURTHOUSE RD
Practice Address - Street 2:SUITE 350
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3853
Practice Address - Country:US
Practice Address - Phone:703-749-0223
Practice Address - Fax:703-749-0225
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01050021232251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA124351Medicare PIN
VAGI124351Medicare ID - Type Unspecified