Individual
NANCY L VITELLO MIKISKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
62 W 7TH AVE STE 450, SPOKANE, WA 99204-2321
(509) 455-8820
(509) 838-4978
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-0001
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003223
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8324261
—
WA
Enumeration date
11/08/2006
Last updated
03/20/2026
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