Individual
ANGELIQUE VICTORIA HOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3896 BEVERLY AVE NE STE 40, SALEM, OR 97305-1374
(503) 588-0076
Mailing address
PO BOX 190, TOPPENISH, WA 98948-0190
(509) 865-2395
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA228517
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
03/02/2026
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