MEDICARE: MAYRA TOSCANO REVELES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1477293124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYRA TOSCANO REVELES

Provider Business Mailing Address
First Line	:	522 W RIVERSIDE AVE STE N
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-0581
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 S ORCAS ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-2442
Country	:	US
Telephone Number	:	206-590-1385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	06/26/2025

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Directions to “ MAYRA TOSCANO REVELES ” Practice Location

Language	Start Address	Practice Location

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