Individual provider Active NPI

Marianne Casilio, MS, CCC-SLP

  • Speech-Language Pathologist
  • Portland, OR
National Provider Identifier
1174005458
Registry record updated Sep 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Phone
(503) 220-8262
NPI assigned
Sep 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964

Mailing address

2109 NW Irving St Unit 305
Portland, OR 97210-3282
Phone (541) 941-7650

Other identifiers 2

IdentifierTypeStateIssuer
14129441OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
16356OtherORSPEECH-LANGUAGE PATHOLOGY LICENSE

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

NPI Registry JSON

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

{
    "created_epoch": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535932800000",
    "number": "1174005458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 NW IRVING ST UNIT 305",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103282",
            "telephone_number": "541-941-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "503-220-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASILIO",
        "first_name": "MARIANNE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-03",
        "last_updated": "2018-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION",
            "identifier": "14129441",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH-LANGUAGE PATHOLOGY LICENSE",
            "identifier": "16356",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2018; 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.