ANDREW NATHAN PETTIBON LMP
NPI 1457579385
Specialist in Tacoma, WA

Q: What is Andrew Pettibon's NPI number?

The NPI number for Andrew Pettibon is 1457579385. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Q: What is Andrew Pettibon's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Andrew Pettibon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 April 23, 2007

4141 6TH AVE, SUITE 2, TACOMA, WA 98406(253) 228-0889 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Andrew Nathan Pettibon Lmp NPPES

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

ANDREW NATHAN PETTIBON LMP (NPI 1457579385) is an individual specialist in Tacoma, Washington, licensed in Washington (MA00056514) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1457579385

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameANDREW NATHAN PETTIBONCredential: LMP

Location Address4141 6TH AVE, SUITE 2Tacoma, WA 98406-4032

Mailing AddressPo Box 65248University Place, WA 98464-1248 · (253) 565-3369

Phone(253) 228-0889

Sole ProprietorYes

Enumeration DateApril 23, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1457579385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in WA · MA00056514

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

4141 6TH AVE, Tacoma, WA 98406

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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 Andrew Pettibon's NPI number?

The NPI number for Andrew Pettibon is 1457579385. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Where is Andrew Pettibon located?

Andrew Pettibon practices at 4141 6th Ave Suite 2, Tacoma, WA 98406. The listed phone number is (253) 228-0889.

What is Andrew Pettibon's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Andrew Pettibon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.