Chad Pettingill

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP.LL.60731420 Issued in WA

Practice address

13416 79TH Avenue CT NW
Gig Harbor, WA 98329-9200

Phone

(253) 312-5672

NPI assigned

Dec 15, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1568906295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13416 79TH AVENUE CT NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983299200",
            "telephone_number": "253-312-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13416 79TH AVENUE CT NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983299200",
            "telephone_number": "253-312-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINGILL",
        "first_name": "CHAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-15",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP10920",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "28065",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "SLP.LL.60731420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Elton DMD PLLC
• Elise Monson Peterson, LMP
• Janis Lynne Peterson, PH.D.
• Robyn M Peterson, LMT
• Karen Diane Petrich, LMP
• Heidi Lorene Phair, M.A.
• Pharos Care Hospice (Pharos Telehealth)
• Carrie Phillips, ND
• Cheyenne Phipps, DPT
• Laura Lee Phipps, LMP

• Speech-Language Pathologist in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.