Healthcare Provider Details

I. General information

NPI: 1144131913
Provider Name (Legal Business Name): VANESSA R. MITCHELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10116 1ST DR SE
EVERETT WA
98208-3961
US

IV. Provider business mailing address

10116 1ST DR SE
EVERETT WA
98208-3961
US

V. Phone/Fax

Practice location:
  • Phone: 480-206-6879
  • Fax:
Mailing address:
  • Phone: 480-206-6879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number60558619
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: