Individual
ANDREW NATHAN PETTIBON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
4141 6TH AVE, SUITE 2, TACOMA, WA 98406-4032
(253) 228-0889
Mailing address
PO BOX 65248, UNIVERSITY PLACE, WA 98464-1248
(253) 565-3369
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00056514
WA
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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