Individual
DR. MARTIN CARLOS HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1717 13TH ST STE 401, EVERETT, WA 98201
(425) 297-6400
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
G067903
CA
207T00000X
Neurological Surgery Physician
Primary
MD60550761
WA
207T00000X
Neurological Surgery Physician
N6359
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212967801
—
TX
01
—
752616977095
TRICARE
TX
01
—
8V3854
BCBS
TX
01
—
GV008Y
MEDICARE PTAN
CA
01
—
GV008Z
MEDICARE PTAN
CA
Enumeration date
02/10/2006
Last updated
05/19/2021
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