Provider Demographics
NPI:1679966006
Name:MACFARLANE, MARY JO (RN)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:JO
Last Name:MACFARLANE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 NE VICTORIAN LN
Mailing Address - Street 2:UNIT C
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2327
Mailing Address - Country:US
Mailing Address - Phone:206-765-7424
Mailing Address - Fax:
Practice Address - Street 1:2213 NE VICTORIAN LN
Practice Address - Street 2:UNIT C
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2327
Practice Address - Country:US
Practice Address - Phone:206-765-7424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60385345163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse