Provider Demographics
NPI:1083705586
Name:COMBEST, DANA KAYE (LM, CPM)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:KAYE
Last Name:COMBEST
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 ADDY GIFFORD RD
Mailing Address - Street 2:
Mailing Address - City:GIFFORD
Mailing Address - State:WA
Mailing Address - Zip Code:99131-9711
Mailing Address - Country:US
Mailing Address - Phone:509-722-3263
Mailing Address - Fax:509-935-8750
Practice Address - Street 1:303 N 2ND STREET W
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-9203
Practice Address - Country:US
Practice Address - Phone:509-935-4108
Practice Address - Fax:509-935-8750
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW00000267175M00000X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No175M00000XOther Service ProvidersMidwife, Lay
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7112121Medicaid