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1700251196
ALLEN GIBSON
BEND, OR
NPI
1700251196
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: OR 00-07-13)
Enumeration Date
2015-12-10
Last Update Date
2015-12-10
Business Address
ALLEN GIBSON
23 NW GREENWOOD AVE
BEND, OR 97703-2078
Phone number: 541-383-4293
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Mailing Address
ALLEN GIBSON
19394 SW LAURELHURST WAY
BEND, OR 97702-3192
Phone number: 541-280-2990
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