Provider Demographics
NPI:1104995851
Name:LAGALBO, REGINA K (MD)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:K
Last Name:LAGALBO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 N 115TH ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133
Mailing Address - Country:US
Mailing Address - Phone:206-363-2800
Mailing Address - Fax:206-363-2811
Practice Address - Street 1:1560 N 115TH ST
Practice Address - Street 2:SUITE 212
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-363-2800
Practice Address - Fax:206-363-2811
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042241207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2568LAOtherREGENCE
WA8449241Medicaid
P00020037OtherRAILROAD MEDICARE
WA8449241Medicaid
WAG8859444Medicare ID - Type Unspecified