Individual
MICHELLE JOY HOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
34515 9TH AVE S, EMERGENCY MEDICINE DEPARTMENT, FEDERAL WAY, WA 98003-6761
(253) 944-7971
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-5947
(800) 336-8614
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
60070611
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0250402
LIWA
WA
01
—
0251022
VCR
WA
01
—
1029HO
BSWA
WA
01
—
1032HO
BSWA
WA
01
—
19577
RESIDENT PERMIT
MN
05
—
8542367
—
WA
01
—
P00744105
RRGA
WA
Enumeration date
05/07/2008
Last updated
08/10/2010
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