Healthcare Provider Details

I. General information

NPI: 1811892961
Provider Name (Legal Business Name): MARISSA PICKETT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 E NOB HILL BLVD
YAKIMA WA
98901-3534
US

IV. Provider business mailing address

2106 S 74TH AVE
YAKIMA WA
98903-3216
US

V. Phone/Fax

Practice location:
  • Phone: 509-248-3334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10035106
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.RN.61271096
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: