Provider Demographics
NPI:1588253702
Name:HOLMES, BILLIE
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9624 S 252ND ST
Mailing Address - Street 2:E105
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-6313
Mailing Address - Country:US
Mailing Address - Phone:253-398-0144
Mailing Address - Fax:
Practice Address - Street 1:9624 S 252ND ST
Practice Address - Street 2:E105
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6313
Practice Address - Country:US
Practice Address - Phone:253-398-0144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider