Provider Demographics
NPI:1154672384
Name:SARVER, MARY JO (ARNP, AOCN, CRNI)
Entity Type:Individual
Prefix:MRS
First Name:MARY JO
Middle Name:
Last Name:SARVER
Suffix:
Gender:F
Credentials:ARNP, AOCN, CRNI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11009 4TH AVE W
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-7073
Mailing Address - Country:US
Mailing Address - Phone:425-514-0176
Mailing Address - Fax:
Practice Address - Street 1:11009 4TH AVE W
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-7073
Practice Address - Country:US
Practice Address - Phone:425-387-0820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00101373163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP30006693OtherARNP