Mary Kathleen Shickich, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD60875348 Issued in WA

Practice address

210 W Galer St
Seattle, WA 98119-3332

Phone

(206) 586-8390

Fax

(206) 895-4792

NPI assigned

Apr 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 30, 2024 through May 30, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Mary Shickich, MD PLLC

  • Psychiatry Physician
  • Seattle, WA
  • NPI 1053081174
  NPD Authorized official

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1669835807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W GALER ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981193332",
            "telephone_number": "206-586-8390",
            "fax_number": "206-895-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W GALER ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981193332",
            "telephone_number": "206-586-8390",
            "fax_number": "206-895-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHICKICH",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60875348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669835807",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wan-Ting Christine Shiao
• Dean Kazuo Shibata, M.D.
• Dennis Shibata
• Eric Ryan Shibley, M.D.
• Grant I Shibuya, M.D.
• Scott Shiebler, PHD, MSW
• Henry Shieh, ARNP
• Justin Shieh, RN
• Allison Nicole Shields, PHD
• Ana Victoria Shields, PT

• Psychiatry Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.