Active NPI
Jill Tracy McManigal, SLP-A
- Speech-Language Assistant
- Marysville, WA
National Provider Identifier
1093053712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SP60300035
- Practice address
- 4220 80TH St NE
Marysville, WA 98270-3423 - Phone
- (360) 657-6731
- NPI assigned
- Jan 30, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SP60300035 | WA | Primary |
| Speech-Language Assistant | 2355S0801X | A0408 | OR |
Addresses
Primary practice location
4220 80TH St NE
Marysville, WA 98270-3423
Mailing address
22815 Lakeview Dr
#G205
Mountlake Terrace, WA 98043-2864
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
| License | State | Type | Specialty |
|---|---|---|---|
| A0408 | OR | MD | Speech-Language Assistant |
| SP60300035 | WA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359504000000",
"number": "1093053712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22815 LAKEVIEW DR",
"address_2": "#G205",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980432864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 80TH ST NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982703423",
"telephone_number": "360-657-6731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMANIGAL",
"first_name": "JILL",
"middle_name": "TRACY",
"credential": "SLP-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-30",
"last_updated": "2013-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "WA",
"license": "SP60300035",
"primary": true
},
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "OR",
"license": "A0408",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.