Active NPI
Holly Marie Gibson, LMP
- Specialist
- Port Hadlock, WA
National Provider Identifier
1023262615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA 60022015
- Practice address
- 310 Hadlock Bay Rd
Port Hadlock, WA 98339-9721 - Phone
- (360) 379-5515
- NPI assigned
- Nov 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA 60022015 | WA | Primary |
Addresses
Primary practice location
310 Hadlock Bay Rd
Port Hadlock, WA 98339-9721
Mailing address
1020 Milo St
Port Townsend, WA 98368-4035
Phone (360) 301-0183
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA 60022015 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226188800000",
"number": "1023262615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 MILO ST",
"city": "PORT TOWNSEND",
"state": "WA",
"postal_code": "983684035",
"telephone_number": "360-301-0183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 HADLOCK BAY RD",
"city": "PORT HADLOCK",
"state": "WA",
"postal_code": "983399721",
"telephone_number": "360-379-5515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "HOLLY",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-09",
"last_updated": "2008-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA 60022015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Hadlock, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.