IndividualActive
Larissa Gibson
NPI 1538097324 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Portland, OR
Provider details
- NPI number
- 1538097324
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- 10143 (OR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
10748 Ne Halsey St
Portland, OR 97220-3961
Phone: (503) 257-9881
Approximate (ZIP-level) locationGet directions
Mailing address
10748 Ne Halsey St
Portland, OR 97220-3961
Registry dates
- Enumerated
- 2026-05-12
- Last updated
- 2026-05-12
- Certified
- 2026-05-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.