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Individual

MS. JODI STICKLER-IVIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1321 COLBY AVE, EVERETT, WA 98201-1665
(425) 261-2000
Mailing address
328 S STILLAGUAMISH AVE, ARLINGTON, WA 98223-1660
(360) 435-6641
(360) 618-7663

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60118008
WA
363AS0400X
Surgical Physician Assistant
PA60118008
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2009940
WA
Enumeration date
12/29/2009
Last updated
03/19/2021
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