Provider Demographics
NPI:1750510681
Name:DELMASTRO, REGINA ANGELA (RN,C)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:ANGELA
Last Name:DELMASTRO
Suffix:
Gender:F
Credentials:RN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 112TH AVE NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2943
Mailing Address - Country:US
Mailing Address - Phone:425-451-9836
Mailing Address - Fax:
Practice Address - Street 1:2025 112TH AVE NE
Practice Address - Street 2:SUITE 300
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2943
Practice Address - Country:US
Practice Address - Phone:425-451-9836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00013558101YA0400X, 101YM0800X
WARN00062371163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health