Provider Demographics
NPI:1962071423
Name:HOLMES, SYLVIA BEATRICE (LMT)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:BEATRICE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4460 RIORDAN HILL DR
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9714
Mailing Address - Country:US
Mailing Address - Phone:607-351-3367
Mailing Address - Fax:
Practice Address - Street 1:4460 RIORDAN HILL DR
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9714
Practice Address - Country:US
Practice Address - Phone:607-351-3367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-20
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22379225700000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist