MEDICARE: MS. REGINA K MYERS LMHP

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	LH00008385	WA

General Provider Information

NPI Number	:	1811185788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REGINA K MYERS LMHP

Provider Business Mailing Address
First Line	:	PO BOX 154
Second Line	:
City	:	DIXIE
State	:	WA
Zip	:	99329-0154
Country	:	US
Telephone Number	:	509-301-3270
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 E MAIN ST STE 201
Second Line	:
City	:	WALLA WALLA
State	:	WA
Zip	:	99362-1900
Country	:	US
Telephone Number	:	509-301-3270
Fax Number	:

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

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	03/28/2022

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