Individual
KIRSTEN A HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 NW 12TH AVE, STE 107, BATTLE GROUND, WA 98604-9141
(360) 687-6650
(360) 514-6820
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA00532
OR
363A00000X
Physician Assistant
Primary
PA10003545
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194918409
—
WA
05
—
500634561
—
OR
Enumeration date
08/20/2007
Last updated
10/14/2020
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