Provider Demographics
NPI:1659303022
Name:MCDONALD-BOWEN, REGINA C (OTR/L,CHT)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:C
Last Name:MCDONALD-BOWEN
Suffix:
Gender:F
Credentials:OTR/L,CHT
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:CARMEL
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-339-5470
Mailing Address - Fax:425-317-4649
Practice Address - Street 1:3927 RUCKER AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4833
Practice Address - Country:US
Practice Address - Phone:425-339-5470
Practice Address - Fax:425-317-4649
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XH1200X
WAOT00003403225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5642BOOtherREGENCE BLUE SHIELD
WA5755189OtherAETNA
WA8474587Medicaid
WA4594BOOtherREGENCE BLUE SHIELD
WA8943885OtherL&I CRIME VICTIMS
WA5457BOOtherREGENCE BLUE SHIELD
WA5734BOOtherREGENCE BLUE SHIELD
WA0217180OtherDEPT OF LABOR & INDUSTRY
WA0268156OtherDEPT OF L&I
WAG8904973Medicare PIN
WA0268156OtherDEPT OF L&I