Healthcare Provider Details

I. General information

NPI: 1902131220
Provider Name (Legal Business Name): DONNA COOMBS LMHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2009
Last Update Date: 10/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 112TH AVE SE STE 221
BELLEVUE WA
98004-6901
US

IV. Provider business mailing address

1400 112TH AVE SE STE 221
BELLEVUE WA
98004-6901
US

V. Phone/Fax

Practice location:
  • Phone: 425-462-5252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number00003413
License Number StateWA

VIII. Authorized Official

Name: MS. DONNA COOMBS
Title or Position: OWNER
Credential: LMHC
Phone: 425-462-5252