Provider Demographics
NPI:1023273851
Name:GIBSON, LINDSEY ERIN (MED)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:ERIN
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ERIN
Other - Last Name:KENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:PO BOX 25283
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97298-0283
Mailing Address - Country:US
Mailing Address - Phone:971-400-5407
Mailing Address - Fax:
Practice Address - Street 1:1110 SE ALDER ST STE 301
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2400
Practice Address - Country:US
Practice Address - Phone:971-400-5407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist