Provider Demographics
NPI:1275631244
Name:COMBS, CHERESE (DNP)
Entity Type:Individual
Prefix:
First Name:CHERESE
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:CHERESE
Other - Middle Name:R
Other - Last Name:TARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:21800 MARKET PL NW STE 104&105
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-6666
Mailing Address - Country:US
Mailing Address - Phone:833-411-5469
Mailing Address - Fax:855-459-3020
Practice Address - Street 1:21800 MARKET PL NW STE 104&105
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6666
Practice Address - Country:US
Practice Address - Phone:206-690-5962
Practice Address - Fax:855-459-3020
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-439A363L00000X
WAAP61287843363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1342925Medicare UPIN
P13949Medicare UPIN