Individual provider · Type 1 NPI

Samantha Gibson, CRM

Peer Specialist · Portland, OR

NPI number 1215897756 Active

Practice location

12612 SE Stark St Bldg M
Portland, OR 97233-1058

Call (503) 906-9995 Map

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000X25-CRM-5008 (OR)

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

4 other providers at this address

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About NPI 1215897756

Samantha Gibson, CRM's National Provider Identifier is 1215897756, issued on Nov 17, 2025. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Portland, OR. The record was last updated on Nov 21, 2025.