Provider Demographics
NPI:1285929760
Name:GIBSON, CHRISTOPHER ANTHONY (DC, ATC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:GIBSON
Suffix:
Gender:M
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6023 35TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3001
Mailing Address - Country:US
Mailing Address - Phone:503-250-3218
Mailing Address - Fax:
Practice Address - Street 1:33400 13TH PL S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6357
Practice Address - Country:US
Practice Address - Phone:253-838-6070
Practice Address - Fax:253-838-6069
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60222207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor