Provider Demographics
NPI:1962669416
Name:NEWCOMB, SUE (L'AC)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:L'AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3523 QUINCE ST SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4105
Mailing Address - Country:US
Mailing Address - Phone:360-290-0314
Mailing Address - Fax:
Practice Address - Street 1:3523 QUINCE ST SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-4105
Practice Address - Country:US
Practice Address - Phone:360-290-0314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003024171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist