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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CAROL ANNE PETTIBONE

Active Sole Proprietor

CAROL ANNE PETTIBONE is a Assisted Living Facility healthcare provider located in WALLA WALLA, Washington. NPI 1114704319 is currently active in the NPPES registry. Verify at CMS.

Assisted Living Facility · WALLA WALLA, WA

Registration Details

NPI Number
1114704319
Provider Type
Individual
Gender
Female
NPI Issued
Sep 11, 2023 (2.9679634250162 yrs)
Last Updated
Sep 11, 2023
License
310601 (WA)
Sole Proprietor
Yes

Practice Information

Address
1840 GRAY LYNN DR
WALLA WALLA, WA, 993629247
Browse WA providers · Browse ZIP 99362
Phone
5095293447
Primary Specialty
Assisted Living Facility
311ZA0620X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.