Healthcare Provider Details

I. General information

NPI: 1083705586
Provider Name (Legal Business Name): DANA KAYE COMBEST LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N 2ND STREET W
CHEWELAH WA
99109-9203
US

IV. Provider business mailing address

2875 ADDY GIFFORD RD
GIFFORD WA
99131-9711
US

V. Phone/Fax

Practice location:
  • Phone: 509-935-4108
  • Fax: 509-935-8750
Mailing address:
  • Phone: 509-722-3263
  • Fax: 509-935-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175M00000X
TaxonomyLay Midwife
License NumberMW00000267
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW00000267
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: