Provider Demographics
NPI:1992691208
Name:KOMOMUA, ALISON (RN)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:KOMOMUA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 W 49TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-5221
Mailing Address - Country:US
Mailing Address - Phone:253-900-9122
Mailing Address - Fax:
Practice Address - Street 1:4703 73RD STREET CT NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8079
Practice Address - Country:US
Practice Address - Phone:253-900-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60073156163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management