Individual
TIMOTHY SCOTT HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
2120 EXCHANGE ST STE 301, ASTORIA, OR 97103-3364
(503) 325-0241
(503) 325-8483
Mailing address
2120 EXCHANGE ST STE 301, ASTORIA, OR 97103-3364
(503) 325-0241
(503) 325-8483
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
091007020N6
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084918
—
OR
Enumeration date
10/03/2006
Last updated
02/03/2014
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