Healthcare Provider Details

I. General information

NPI: 1730321142
Provider Name (Legal Business Name): REGINE LYNE-CARTER LMP, LE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2009
Last Update Date: 03/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 132ND AVE NE
KIRKLAND WA
98033-8628
US

IV. Provider business mailing address

18558 NE 57TH ST
REDMOND WA
98052-6113
US

V. Phone/Fax

Practice location:
  • Phone: 425-822-4326
  • Fax:
Mailing address:
  • Phone: 206-595-5937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60074761
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA60074761
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: