Individual
CHRISTINA PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1210 SW 136TH ST, BURIEN, WA 98166-1214
(206) 257-6972
Mailing address
9165 45TH AVE SW APT 2, SEATTLE, WA 98136-2673
(206) 930-9359
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN60057774
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN60057774
REGISTERED NURSE
WA
Enumeration date
10/11/2018
Last updated
10/11/2018
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