Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carol Anne Pettibone

Individual provider Adult Care Home Facility · NPI 1114704319

Carol Anne Pettibone is an Adult Care Home Facility in Walla Walla, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2023

Practice location Address checks out

1840 Gray Lynn Dr
Walla Walla, WA 99362-9247
Phone: (509) 529-3447
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Care Home Facility (primary) Taxonomy 311ZA0620X · Licence 310601 (WA)

Record details

NPI number1114704319
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 11, 2023
Last updated in NPPESSeptember 11, 2023
Certification dateSeptember 11, 2023