Provider Demographics
NPI:1558629931
Name:COOMES, DEBRA LYNN
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:COOMES
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 1:1360 N LOUISIANA ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7171
Mailing Address - Country:US
Mailing Address - Phone:509-735-4247
Mailing Address - Fax:509-735-7788
Practice Address - Street 1:1360 N LOUISIANA ST
Practice Address - Street 2:SUITE D
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7171
Practice Address - Country:US
Practice Address - Phone:509-735-4247
Practice Address - Fax:509-735-7788
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management