| Doctor Name: | MRS. MELISSA THIBAULT MIKOTA |
| NPI Number: | 1346673910 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | AP 60401482 |
| Business Practice Address: | 518 W 1st Ave Toppenish, WA - 989481564 |
| Business Phone Number: | 5098655600 |
| Business Fax Number: | |
| Mailing Address: | 302 N 27th Ave, YAKIMA |
| State: | WA |
| Postal Code: | 989022323 |
| Phone Number: | 7733964131 |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2013 |
| NPI Last Update Date: | 06/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP 60401482 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |