Jacob Gibson

NPI 1477411239 · on the registry since 2026

Practice

Address: 17720 Ne Halsey St Ste A
Portland, OR 97230
Phone: (503) 654-7654
Fax: (503) 654-7333
Organisation at this address: Columbacare Services
Columbiacare Services
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 110

Registry record

Primary taxonomy: 163WP0809X
163WP0809X
Licence states on file: OR
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-01-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon