JACOB R. GIBSON – NPI #1477411239
Registered Nurse

JACOB GIBSON is a registered nurse (RN) located in PORTLAND, OR. NPPES has assigned the NPI number 1477411239 to JACOB GIBSON on January 12, 2026. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 163WP0809X from the Health Care Provider Taxonomy code set, which is classified as Registered Nurse, specializing in Psychiatric/Mental Health, Adult

The NPI profile was last updated on Jan 13, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JACOB GIBSON below.

NPI Profile for
JACOB R. GIBSON

NPI Number
1477411239
Enumeration Date

(about 5 months ago)
Entity Type
Type-1  Individual
Legal Name
JACOB R. GIBSON
Primary location
17720 NE HALSEY ST STE A
PORTLAND, OR 97230-6771
Phone: (503) 654-7654 Fax: (503) 654-7333
Mailing address
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone: (541) 858-8170 Fax: (541) 858-8167
Sole Proprietor
No
Updated
Certification Date
Jan 13, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
163WP0809X
- Registered Nurse / Psychiatric/Mental Health, Adult (Primary)		 OR 10051976

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.