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Carol Pettibone
NPI 1114704319 · on the registry since 2023 · sole proprietor
Practice
- Address
- 1840 Gray Lynn Dr
Walla Walla, WA 99362 - Phone
- (509) 529-3447
Registry record
- Primary taxonomy
- Adult Care Home Facility
311ZA0620X
- Licence states on file
- WA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-09-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington