Shelly Grace Lozano Mariano, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

61206262 Issued in WA

Practice address

12036 64TH Ave S
Seattle, WA 98178-3603

Phone

(206) 785-5898

NPI assigned

Dec 27, 2017

Last updated

Feb 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Playbox Pediatric Therapy

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1629778386

  Speech-Language Pathologist

  NPD Authorized official

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677369600000",
    "number": "1063928125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12036 64TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981783603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12036 64TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981783603",
            "telephone_number": "206-785-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANO",
        "first_name": "SHELLY GRACE",
        "middle_name": "LOZANO",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-27",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "61206262",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111524501",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Elisabeth Mari, MD
• Maria Taylor Nutrition LLC
• Haytham E Maria, M.D.
• Anthony Joseph Mariano, PHD
• Maryjean Mariano, PH.D.
• Sonia Elise Mariano, M.D.
• Clementine Marie, LMT
• Kacie Marie, MS, MA, LMHCA
• Colette Alyse Marien, L.AC, EAMP
• Jessica Mariluch, ND

• Speech-Language Pathologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2023; 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.