Provider Demographics
NPI:1033921226
Name:GIBSON, ALISON E
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:E
Last Name:GIBSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16229 NW FESCUE CT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-1657
Mailing Address - Country:US
Mailing Address - Phone:503-505-0528
Mailing Address - Fax:
Practice Address - Street 1:16229 NW FESCUE CT
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-1657
Practice Address - Country:US
Practice Address - Phone:503-505-0528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education