Provider Demographics
NPI:1295095628
Name:REGAN, JADE LUU (DO)
Entity type:Individual
Prefix:DR
First Name:JADE
Middle Name:LUU
Last Name:REGAN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:NGOC
Other - Middle Name:QUOC
Other - Last Name:LUU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:801 S STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2654
Mailing Address - Country:US
Mailing Address - Phone:509-363-7788
Mailing Address - Fax:
Practice Address - Street 1:801 S STEVENS ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2654
Practice Address - Country:US
Practice Address - Phone:509-363-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53150542902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2097624Medicaid