Individual provider Active NPI

Marielle Virginia McKean, M.A., SLP

  • Speech-Language Pathologist
  • Bend, OR
National Provider Identifier
1326592098
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016215 Issued in OR
Practice address
2600 NE Neff Rd
Bend, OR 97701-6337
Phone
(541) 706-6843
Fax
(541) 398-3444
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X PSLP.0000159 CO
Speech-Language Pathologist 235Z00000X 016215 OR Primary

Addresses

Primary practice location

2600 NE Neff Rd
Bend, OR 97701-6337

Mailing address

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 382-4321

Other practice location 1

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 382-4321

Other practice location 2

5280 Newton St
Denver, CO 80221-7328
Phone (509) 750-2705

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PSLP.0000159COMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1326592098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016015",
            "telephone_number": "541-382-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016337",
            "telephone_number": "541-706-6843",
            "fax_number": "541-398-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 NE Neff Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016015",
            "country_code": "US",
            "telephone_number": "541-382-4321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5280 Newton St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802217328",
            "country_code": "US",
            "telephone_number": "509-750-2705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEAN",
        "first_name": "MARIELLE",
        "middle_name": "VIRGINIA",
        "credential": "M.A., SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "PSLP.0000159",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "016215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.