Provider Demographics
NPI:1609227701
Name:M. ROMO, MARIANA (MA, MSW)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:M. ROMO
Suffix:
Gender:F
Credentials:MA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LENORA ST # 795
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2411
Mailing Address - Country:US
Mailing Address - Phone:415-779-6090
Mailing Address - Fax:
Practice Address - Street 1:300 LENORA ST # 795
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2411
Practice Address - Country:US
Practice Address - Phone:415-779-6090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60473835101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health