=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093800682
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REGINA CURRIER DPM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5 NE 4TH ST
-----------------------------------------------------
City | COUPEVILLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98239-1705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-522-6640
-----------------------------------------------------
Fax | 206-527-0147
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1705 5 NE 4TH ST
-----------------------------------------------------
City | COUPEVILLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98239-1705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-522-6640
-----------------------------------------------------
Fax | 206-527-0147
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | PO00000451
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------