Brettyn Carole Gibson

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

61000756 Issued in WA

Practice address

309 W 12TH St
Vancouver, WA 98660-2903

Phone

(360) 334-5575

Fax

(360) 695-9803

NPI assigned

Sep 11, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1578593562
  Medicare reassignment NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1275187429
  NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1275567539
  NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1326443383
  NPD
• Children'S Home Society of Washington

  • Community/Behavioral Health Agency
  • Vancouver, WA
  • NPI 1063566867
  NPD (past)

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1629551189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W 12TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W 12TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602903",
            "telephone_number": "360-334-5575",
            "fax_number": "360-695-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "BRETTYN",
        "middle_name": "CAROLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "61000756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980234",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Mae Gibbons, DPT
• Karen Lynn Gibbs, LICSW
• Debra Jean Gibeson
• Zeweditu T Gibrehiwot
• Ollie Gibson-Lavell, LICSW
• Crystal Gibson, LPN
• Skyler August Gideon, FNP-C
• Todd W Gienapp, D.O.
• Laurinda Silva Giffin, CPCP
• Caylee Gil

• Marriage & Family Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.