Provider Demographics
NPI:1497085518
Name:COMSTOCK, TONYA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:TONYA
Middle Name:L
Last Name:COMSTOCK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MS 315010
Mailing Address - Street 2:PO BOX 3947
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124
Mailing Address - Country:US
Mailing Address - Phone:425-635-6731
Mailing Address - Fax:
Practice Address - Street 1:1740 NW MAPLE ST
Practice Address - Street 2:STE 111
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027
Practice Address - Country:US
Practice Address - Phone:425-394-1200
Practice Address - Fax:425-384-0100
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
WAPY60706823103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist