Provider Demographics
NPI:1578621868
Name:REGAN-HUGHES, ROBERT WARNER (LMP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WARNER
Last Name:REGAN-HUGHES
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8523 NE 142ND ST.
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-442-0785
Mailing Address - Fax:425-658-7305
Practice Address - Street 1:515 KIRKLAND WAY
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6219
Practice Address - Country:US
Practice Address - Phone:425-442-0785
Practice Address - Fax:425-658-7305
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004916225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA35818OtherWA DEPT. OF L & I
WARE6033OtherREGENCE BLUE SHIELD
WA66525OtherJOHNSTON AND CULBERTSON
WA8919832OtherWA L&I CRIME VICTIMS
WA8919832OtherWA L&I CRIME VICTIMS