Individual
REGINA A EWING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
345 S 5TH ST, MADRAS, OR 97741-1501
(904) 846-8574
Mailing address
345 S 5TH ST, MADRAS, OR 97741-1501
(904) 846-8574
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
PA209746
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437404639
—
TX
Enumeration date
07/13/2012
Last updated
10/04/2025
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