Individual
DR. CLYDE FREDERICK HOLLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 W 5TH AVE, SUITE 518, SPOKANE, WA 99204-2823
(509) 747-3147
(509) 747-0020
Mailing address
5447 S QUAIL RIDGE CIR, SPOKANE, WA 99223-6390
(509) 443-1183
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD000131151
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14965
L& I NUMBER
WA
01
—
340011680
RRB
WA
05
—
8249906
—
WA
Enumeration date
08/25/2006
Last updated
03/18/2010
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