Provider Demographics
NPI:1922073881
Name:MCCOMB, TOMAS STEWART STILES (MSPT CSCS)
Entity Type:Individual
Prefix:
First Name:TOMAS
Middle Name:STEWART STILES
Last Name:MCCOMB
Suffix:
Gender:M
Credentials:MSPT CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N EVEREST RD STE C
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2116
Mailing Address - Country:US
Mailing Address - Phone:503-538-8952
Mailing Address - Fax:503-537-2027
Practice Address - Street 1:120 N EVEREST RD STE C
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2116
Practice Address - Country:US
Practice Address - Phone:503-538-8952
Practice Address - Fax:503-537-2027
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3447225100000X
WA8711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR004583013OtherBLUE CROSS
OR004583013OtherBLUE CROSS