Individual
JACKSON RILEY HOLLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 COOKS HILL RD, CENTRALIA, WA 98531-9072
(360) 736-0168
(360) 330-8784
Mailing address
PO BOX 11009, OLYMPIA, WA 98508-1009
(360) 352-2037
(360) 352-0637
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
13619
WA
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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