Individual provider Active NPI

Mrunmayee Manohar Shete, MS

  • Genetic Counselor (M.S.)
  • Seattle, WA
National Provider Identifier
1104431014
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
GT61168901 Issued in WA
Practice address
1229 Madison St Ste 750
Seattle, WA 98104-3540
Phone
(206) 386-2101
Fax
(206) 386-2555
NPI assigned
Sep 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X GT61168901 WA Primary

Addresses

Primary practice location

1229 Madison St Ste 750
Seattle, WA 98104-3540

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
2231846MedicaidWA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
GT61168901WAMDGenetic Counselor (M.S.)

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1104431014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 MADISON ST STE 750",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043540",
            "telephone_number": "206-386-2101",
            "fax_number": "206-386-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETE",
        "first_name": "MRUNMAYEE",
        "middle_name": "MANOHAR",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "WA",
            "license": "GT61168901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2231846",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.