Provider Demographics
NPI:1225880941
Name:MCOMBER, BETH ANN
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:MCOMBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:MINKLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NREMT
Mailing Address - Street 1:6751 34TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-4207
Mailing Address - Country:US
Mailing Address - Phone:530-220-5953
Mailing Address - Fax:
Practice Address - Street 1:2000 W MARINE VIEW DR BLDG 2108
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98207-5000
Practice Address - Country:US
Practice Address - Phone:425-304-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1710I1003X
WALR60971320227900000X
E3223972146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered