Individual
MS. LISA ANN PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-2252
(253) 968-3278
Mailing address
MADIGAN ARMY MEDICAL CENTER, 9040 REID ST., ATTN: MCHJ-QCR, TACOMA, WA 98431-0001
(253) 968-2252
(253) 968-3278
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
107635
MO
Other
Enumeration date
01/19/2006
Last updated
07/10/2019
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