Provider Demographics
NPI:1740829928
Name:GIBSON, KARLIE (RN, LMHCA)
Entity type:Individual
Prefix:
First Name:KARLIE
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:RN, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7263
Mailing Address - Country:US
Mailing Address - Phone:602-909-5313
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-7263
Practice Address - Country:US
Practice Address - Phone:602-909-5313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-05
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA60989257163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program