Most Relevant Information
Provider Data
| NPI Number: | 1003214420 |
| Provider Name: | ASHLEY PETTIS BS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/17/2014 |
| Last Updated: | 12/17/2014 |
Provider Practice Location
9330 59TH AVE SW
LAKEWOOD
WA
984992858
Practice Location Phone/Fax
| Phone: | 2536205015 |
| Fax: |
Provider Mailing Location
9330 59TH AVE SW
LAKEWOOD
WA
984992858
Provider Mailing Phone/Fax
| Phone: | 2536205015 |
| Fax: |