Individual
REGINA ANN SOMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
1601 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 397-8246
(360) 397-8450
Mailing address
123 E 44TH ST, VANCOUVER, WA 98663-1829
(360) 773-4241
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60977634
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO60977634
WA STATE LICENCE
WA
Enumeration date
08/29/2019
Last updated
07/24/2023
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