Provider Demographics
NPI:1124626007
Name:REGULUS COUNSELING PLLC
Entity type:Organization
Organization Name:REGULUS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-395-6088
Mailing Address - Street 1:2916 NW BUCKLIN HILL RD # 109
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8514
Mailing Address - Country:US
Mailing Address - Phone:321-302-2000
Mailing Address - Fax:
Practice Address - Street 1:701 5TH AVE STE 42
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-7097
Practice Address - Country:US
Practice Address - Phone:206-395-6088
Practice Address - Fax:206-350-9033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1043950094Medicaid