Lisa Camille Gibson, RN BSN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

Practice address

722 NE 162ND Ave
Albertina Kerr Center Youth & Family Services
Portland, OR 97024

Phone

(503) 255-4205

NPI assigned

Apr 9, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1467625632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 NE 162ND AVE",
            "address_2": "ALBERTINA KERR CENTER YOUTH & FAMILY SERVICES",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97024",
            "telephone_number": "503-255-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 NE 162ND AVE",
            "address_2": "ALBERTINA KERR CENTER YOUTH & FAMILY SERVICES",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97024",
            "telephone_number": "503-255-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "LISA",
        "middle_name": "CAMILLE",
        "name_prefix": "Ms.",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Ryan Gibson
• Jennifer Anne Gibson
• Jennifer M. Gibson, MD
• Larissa Gibson
• Lindsey Erin Gibson, MED
• Madeline Jane Gibson
• Margaret Gibson, OTD, OTR/L
• Mark Alan Gibson, MD
• Nancy Marie Gibson, FNP
• Owen Gibson, M.A.

• Psychiatric/Mental Health Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.

Verify at the official NPI Registry.