Provider Demographics
NPI:1932226909
Name:PETETT, ANNE R (DC)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:R
Last Name:PETETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10622 SE CARR RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5824
Mailing Address - Country:US
Mailing Address - Phone:425-277-2225
Mailing Address - Fax:425-277-1591
Practice Address - Street 1:10622 SE CARR RD
Practice Address - Street 2:SUITE A
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5824
Practice Address - Country:US
Practice Address - Phone:425-277-2225
Practice Address - Fax:425-277-1591
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8427023OtherDSHS
WA140347OtherLABOR AND INDUSTRIES