Individual
JUSTIN HOLLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
13820 19TH AVE NE, TULALIP, WA 98271-6706
(425) 231-8545
Mailing address
6724 73RD ST NE, MARYSVILLE, WA 98270-7713
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60230777
WA
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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