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1861171308
STEPHANIE GIBSON
DALLAS, OR
NPI
1861171308
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
(Licence: OR THW000109289)
Enumeration Date
2023-07-12
Last Update Date
2023-07-12
Business Address
STEPHANIE GIBSON PSS
945 SE UGLOW AVE
DALLAS, OR 97338-2642
Phone number: 503-837-1762
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Mailing Address
STEPHANIE GIBSON PSS
1401 W ELLENDALE AVE UNIT 81
DALLAS, OR 97338-1367
Phone number:
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