CAROL ANNE PETTIBONE
NPI 1114704319
Custodial Care Facility - Adult Care Home in Walla Walla, WA

Q: What is Carol Pettibone's NPI number?

The NPI number for Carol Pettibone is 1114704319. It was assigned to this individual provider in the NPPES registry on September 11, 2023.

Q: What is Carol Pettibone's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Q: When was this NPI record last updated?

The NPPES record for Carol Pettibone was last updated on September 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 11, 2023

1840 GRAY LYNN DR, WALLA WALLA, WA 99362(509) 529-3447 Get Directions Write a Review

NPPES record last updated: September 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Carol Anne Pettibone NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAROL ANNE PETTIBONE (NPI 1114704319) is an individual adult care home provider in Walla Walla, Washington, licensed in Washington (310601) and active in the NPI registry since September 2023.

NPPES Registry Identity

NPI1114704319

Entity TypeIndividualFemale

Primary Taxonomy311ZA0620X

Provider Legal NameCAROL ANNE PETTIBONE

Location Address1840 GRAY LYNN DRWalla Walla, WA 99362-9247

Mailing Address1840 Gray Lynn DrWalla Walla, WA 99362-9247 · (509) 529-3447

Phone(509) 529-3447

Sole ProprietorYes

Enumeration DateSeptember 11, 2023

NPPES CertifiedSeptember 11, 2023

✔ NPI 1114704319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities

Taxonomy Code311ZA0620X

License✔ Licensed in WA · 310601

Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

1840 GRAY LYNN DR, Walla Walla, WA 99362

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carol Pettibone's NPI number?

The NPI number for Carol Pettibone is 1114704319. It was assigned to this individual provider in the NPPES registry on September 11, 2023.

Where is Carol Pettibone located?

Carol Pettibone practices at 1840 Gray Lynn Dr, Walla Walla, WA 99362. The listed phone number is (509) 529-3447.

What is Carol Pettibone's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Carol Pettibone was last updated on September 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.