Provider Demographics
NPI:1285076737
Name:PANKO, NANCY BISHOP (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:BISHOP
Last Name:PANKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 SE BISHOP BLVD
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-5517
Mailing Address - Country:US
Mailing Address - Phone:509-338-0632
Mailing Address - Fax:
Practice Address - Street 1:825 SE BISHOP BLVD STE 130
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5517
Practice Address - Country:US
Practice Address - Phone:509-338-0632
Practice Address - Fax:509-715-2130
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-14870208600000X
WAMD60966937208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty