Healthcare Provider Details

I. General information

NPI: 1104789791
Provider Name (Legal Business Name): KIANA GRACE PIELLI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 8TH AVE
SPOKANE WA
99204-2307
US

IV. Provider business mailing address

12202 E MAXWELL AVE APT A106
SPOKANE VALLEY WA
99206-4981
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTA70045744
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: