Provider Demographics
NPI:1730321142
Name:LYNE-CARTER, REGINE (LMP, LE)
Entity Type:Individual
Prefix:MS
First Name:REGINE
Middle Name:
Last Name:LYNE-CARTER
Suffix:
Gender:F
Credentials:LMP, LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18558 NE 57TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6113
Mailing Address - Country:US
Mailing Address - Phone:206-595-5937
Mailing Address - Fax:
Practice Address - Street 1:6515 132ND AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8628
Practice Address - Country:US
Practice Address - Phone:425-822-4326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60074761172M00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist