Provider Demographics
NPI:1104095876
Name:DENIS R. HOLMES, O.D.
Entity type:Organization
Organization Name:DENIS R. HOLMES, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:360-734-5390
Mailing Address - Street 1:414 GIRARD ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4004
Mailing Address - Country:US
Mailing Address - Phone:360-734-5390
Mailing Address - Fax:360-734-8283
Practice Address - Street 1:414 GIRARD ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4004
Practice Address - Country:US
Practice Address - Phone:360-734-5390
Practice Address - Fax:360-734-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1594152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA001446201OtherMEDICARE
WA410004982OtherRR MEDICARE
WA2008191Medicaid
WA001446200OtherMEDICARE