SAM L PETTIBON D.O.
NPI 1386860492
Chiropractor - Rehabilitation in Federal Way, WA

Active since April 17, 2007Accepts Medicare Assignment
30804 PACIFIC HWY S, FEDERAL WAY, WA 98003(253) 839-5644(253) 839-2625 Get Directions Write a Review

NPPES record last updated: May 2, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Sam L Pettibon D.o. NPPES

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

SAM L PETTIBON D.O. (NPI 1386860492) is an individual rehabilitation provider in Federal Way, Washington, licensed in Washington (2174) and active in the NPI registry since April 2007. He is a graduate of Life Chiropractic College - West (1985).

NPPES Registry Identity

NPI1386860492
Entity TypeIndividualMale
Primary Taxonomy111NR0400X
Provider Legal NameSAM L PETTIBONCredential: D.O.
Location Address30804 PACIFIC HWY SFederal Way, WA 98003-4902
Mailing Address30804 Pacific Hwy SFederal Way, WA 98003-4902 · (253) 839-5644 · Fax (253) 839-2625
Fax(253) 839-2625
Sole ProprietorNo
Medical School CMSLife Chiropractic College - WestGraduated 1985
Enumeration DateApril 17, 2007
Last NPPES UpdateMay 2, 2012
NPI 1386860492 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyChiropractor · RehabilitationChiropractic Providers
Taxonomy Code111NR0400X
License Licensed in WA · 2174
Definition

Rehabilitation is the discipline focused on restoring a patient's functional abilities to pre-injury or pre-disease status. Functional abilities are defined as those activities in one's daily life, work, or sports and recreational activities that an individual participates in. Relevant impairments (e.g. strength, endurance, flexibility, motor control, etc.) are often intermediate goals of rehabilitation, but the final goal of successful care is return to participation in activities in which the patient was successful before the onset of the injury or disease. Essential to a rehabilitation approach is a focus on patient-centered outcomes such as independence and self-management or self-care skills.

30804 PACIFIC HWY S, Federal Way, WA 98003

Other Identifiers 5

Medicare ID-Type Unspecified000106746WA
OtherPE5678WA · Regence Insurance Provide
Medicaid2007078WA
Other73321WA · L & I Provider
Medicare PIN000106746

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Sam L Pettibon D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678721099
PECOS Enrollment IDI20120910000606

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 3-4 spinal regions 98941
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
400 services16 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Chiropractor
30804 PACIFIC HWY S
FEDERAL WAY, WA 98003

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1386860492, enumerated as an "individual" on April 17, 2007.

The provider is located at 30804 PACIFIC HWY S FEDERAL WAY, WA 98003 and the phone number is (253) 839-5644.

Chiropractor with taxonomy code 111NR0400X and a focus in Rehabilitation.

The provider might be accepting Accepts: PacificSource Health Plans, Premera Blue Cross. Please consult your insurance carrier or call the provider to verify.