NPI 1114285376
Lynette Michelle Petibone
Practice location
- Address
- 14104 SW 121st Ave, Tigard, OR 97224-2818
- Phone
- (503) 443-6902
Registered specialties (3)
Midwife
Primary
Midwife
Registry record
- NPI
- 1114285376
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 25 Apr 2012
- Record last updated
- 12 Apr 2017
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.