Provider Demographics
NPI:1205699873
Name:MCCOMB, DENA
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:MCCOMB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9511 W WASHAM CT
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-8623
Mailing Address - Country:US
Mailing Address - Phone:253-278-5534
Mailing Address - Fax:
Practice Address - Street 1:9511 W WASHAM CT
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004-8623
Practice Address - Country:US
Practice Address - Phone:253-278-5534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach