Provider Demographics
NPI:1083366991
Name:EVERETT, MARIA ALENE (ARNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ALENE
Last Name:EVERETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9425 N NEVADA ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1286
Mailing Address - Country:US
Mailing Address - Phone:509-270-0065
Mailing Address - Fax:509-319-2520
Practice Address - Street 1:9425 N NEVADA ST STE 104
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1294
Practice Address - Country:US
Practice Address - Phone:509-866-0200
Practice Address - Fax:509-866-0047
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61224996363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics