Individual provider Active NPI

Melissa D Mamiya, SLP

  • Specialist
  • Lynnwood, WA
National Provider Identifier
1033305446
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
LL00004668 Issued in WA
Practice address
20818 44TH Ave W # 270P
Lynnwood, WA 98036-7709
Phone
(425) 672-2716
NPI assigned
Sep 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X LL00004668 WA Primary

Addresses

Primary practice location

20818 44TH Ave W # 270P
Lynnwood, WA 98036-7709

Mailing address

20818 44TH Ave W # 270P
Lynnwood, WA 98036-7709
Phone (425) 672-2716

Other identifiers 1

IdentifierTypeStateIssuer
7018518MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LL00004668WAMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1033305446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20818 44TH AVE W # 270P",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367709",
            "telephone_number": "425-672-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20818 44TH AVE W # 270P",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367709",
            "telephone_number": "425-672-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMIYA",
        "first_name": "MELISSA",
        "middle_name": "D",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "LL00004668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7018518",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.