Provider Demographics
NPI:1689474637
Name:COMBS, KIMBERLEY LUCILE
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:LUCILE
Last Name:COMBS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 SE CHOKEBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:OR
Mailing Address - Zip Code:97146-7340
Mailing Address - Country:US
Mailing Address - Phone:503-861-4221
Mailing Address - Fax:
Practice Address - Street 1:2002 SE CHOKEBERRY AVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-7340
Practice Address - Country:US
Practice Address - Phone:503-861-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator