Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 025209 | WA |
NPI | 1134167620 |
---|---|
Provider Name | Dr. Roberta Haynes De Regt |
First Address | Bellevue, WA 98004-4623 |
Second Address | Bellevue, WA 98004-4623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 08/07/2007 |