Provider Demographics
NPI:1720978471
Name:HOLMES, ERIC TIMOTHY
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:TIMOTHY
Last Name:HOLMES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 KENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8211
Mailing Address - Country:US
Mailing Address - Phone:541-391-9446
Mailing Address - Fax:
Practice Address - Street 1:26815 DOBLE DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-9024
Practice Address - Country:US
Practice Address - Phone:541-391-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant