Healthcare Provider Details

I. General information

NPI: 1073441200
Provider Name (Legal Business Name): MS. TOSHA RANEE PICKELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14819 E MISSION AVE
SPOKANE VALLEY WA
99216-1960
US

IV. Provider business mailing address

18 W 2ND ST APT 211
CHENEY WA
99004-1465
US

V. Phone/Fax

Practice location:
  • Phone: 509-315-9791
  • Fax: 509-474-9612
Mailing address:
  • Phone: 509-263-4041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCG70092193
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: