Provider Demographics
NPI:1992298889
Name:ANSON, REGEENA NICOLE
Entity type:Individual
Prefix:MRS
First Name:REGEENA
Middle Name:NICOLE
Last Name:ANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15707 4TH AVE S APT 33
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1283
Mailing Address - Country:US
Mailing Address - Phone:206-999-3260
Mailing Address - Fax:
Practice Address - Street 1:715 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2066
Practice Address - Country:US
Practice Address - Phone:206-682-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant