Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Ryan Gibson

Individual provider Adult Psychiatric/Mental Health Registered Nurse · NPI 1477411239

Jacob Ryan Gibson is an Adult Psychiatric/Mental Health Registered Nurse in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2026.

Licensed in
OR
In the registry since
2026

Practice location Address checks out

17720 NE Halsey St Ste A
Portland, OR 97230-6771
Phone: (503) 654-7654
Fax: (503) 654-7333
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Psychiatric/Mental Health Registered Nurse (primary) Taxonomy 163WP0809X · Licence 10051976 (OR)

Record details

NPI number1477411239
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedJanuary 12, 2026
Last updated in NPPESJanuary 13, 2026
Certification dateJanuary 13, 2026
Mailing address3587 Heathrow Way, Medford, OR 97504-4004

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