Healthcare Provider Details

I. General information

NPI: 1750510681
Provider Name (Legal Business Name): REGINA ANGELA DELMASTRO RN.,C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2009
Last Update Date: 07/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 112TH AVE NE SUITE 300
BELLEVUE WA
98004-2943
US

IV. Provider business mailing address

2025 112TH AVE NE SUITE 300
BELLEVUE WA
98004-2943
US

V. Phone/Fax

Practice location:
  • Phone: 425-451-9836
  • Fax:
Mailing address:
  • Phone: 425-451-9836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRC00013558
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberRC00013558
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN00062371
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: