MEDICARE: MARIANA M. ROMO MA, MSW

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	101YM0800X	Mental Health Counselor	60473835	WA

General Provider Information

NPI Number	:	1609227701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANA M. ROMO MA, MSW

Provider Business Mailing Address
First Line	:	300 LENORA ST # 795
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2411
Country	:	US
Telephone Number	:	415-779-6090
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 LENORA ST # 795
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2411
Country	:	US
Telephone Number	:	415-779-6090
Fax Number	:

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

Provider Enumeration Date	:	06/29/2016
Last Update Date	:	12/07/2020

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