Lynette Michelle Petibone

Midwife · Tigard, OR

Individual Active NPI

NPI number 1114285376

Practice location

14104 SW 121st Ave
Tigard, OR 97224-2818
Phone
(503) 443-6902

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NPI record

NPI
1114285376
Entity type
Individual (Type 1)
Enumeration date
April 25, 2012
Last updated
April 12, 2017
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Midwife Primary 176B00000X DEM-LD-10182635 OR
Doula 374J00000X P301 CA
Midwife 176B00000X MW60719565 WA

About Lynette Petibone

Lynette Michelle Petibone is a healthcare provider registered in the NPI registry with the primary taxonomy Midwife (code 176B00000X). The practice location is 14104 SW 121st Ave, Tigard, OR 97224-2818. The NPI number 1114285376 was assigned on April 25, 2012 and the record was last updated on April 12, 2017.

Lynette Petibone lists 3 licenses in the registry: #DEM-LD-10182635 (OR) for Midwife; #P301 (CA) for Doula; #MW60719565 (WA) for Midwife. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Lynette Michelle Petibone?

The NPI number is 1114285376.

What is the phone number of Lynette Petibone?

The phone number listed for the practice location is (503) 443-6902.

Where is Lynette Petibone located?

14104 SW 121st Ave, Tigard, OR 97224-2818.

What is the taxonomy code for Lynette Petibone?

The primary taxonomy code is 176B00000X – Midwife; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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