Provider Demographics
NPI:1649755711
Name:SCHREVEN, MARIAH (ARNP, RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIAH
Middle Name:
Last Name:SCHREVEN
Suffix:
Gender:F
Credentials:ARNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7902 E WOODLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-3512
Mailing Address - Country:US
Mailing Address - Phone:509-724-0148
Mailing Address - Fax:
Practice Address - Street 1:7902 E WOODLAND PARK DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-3512
Practice Address - Country:US
Practice Address - Phone:509-724-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60402193163WG0000X
WAAP60901520363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP60901520Medicaid
WARN60402193Medicaid