Individual
NISHA KHANAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4001 TIETON DR, YAKIMA, WA 98908-3345
(509) 410-0746
(509) 410-0749
Mailing address
PO BOX 5999, PORTLAND, OR 97228-5999
(541) 500-2500
(541) 500-2700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61198230
WA
363AS0400X
Surgical Physician Assistant
2945
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2192132
—
WA
Enumeration date
09/25/2018
Last updated
04/26/2023
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