Provider Demographics
NPI:1669169082
Name:GIBBONS, COLIMA M (RN)
Entity type:Individual
Prefix:
First Name:COLIMA
Middle Name:M
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S 189TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98148-2040
Mailing Address - Country:US
Mailing Address - Phone:206-252-2807
Mailing Address - Fax:206-743-3177
Practice Address - Street 1:420 S 189TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98148-2040
Practice Address - Country:US
Practice Address - Phone:206-252-2807
Practice Address - Fax:206-743-3177
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60280469163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool