Individual
ROBERT W MIKISKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1550 S PIONEER WAY STE 100, MOSES LAKE, WA 98837-4637
(509) 793-9790
(509) 764-3255
Mailing address
1550 S PIONEER WAY STE 100, MOSES LAKE, WA 98837-4637
(509) 793-9790
(509) 764-3255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA10003227
WA
363A00000X
Physician Assistant
Primary
PA10003227
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659383842
—
MT
05
—
8324220
—
WA
Enumeration date
08/13/2006
Last updated
06/18/2021
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