IndividualActive
Lynette Petibone
NPI 1114285376 · Midwife · Tigard, OR
Provider details
- NPI number
- 1114285376
- Entity type
- Individual
- Primary specialty
- MidwifeOther Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- P301 (CA)
Specialties & taxonomies
Other Service Providers
Nursing Service Related Providers
Other Service Providers
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
14104 Sw 121st Ave
Tigard, OR 97224-2818
Phone: (503) 443-6902
Street-level locationGet directions
Mailing address
14104 Sw 121st Ave
Tigard, OR 97224-2818
Registry dates
- Enumerated
- 2012-04-25
- Last updated
- 2017-04-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.