Individual
KIMBERLY J CALNAN-HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
16818 E DESMET CT, SPOKANE VALLEY, WA 99216-3542
(509) 456-5380
(509) 456-5381
Mailing address
2517 NE KRESKY AVE, PO BOX 1506, CHEHALIS, WA 98532-2409
(360) 784-8632
(360) 748-3869
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3437
WA
152W00000X
Optometrist
Primary
OD00003437
WA
152W00000X
Optometrist
ODP-100200
ID
152W00000X
Optometrist
OPT-OPT-LIC-579
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0135439
L & I
WA
05
—
1019169
—
WA
01
—
1594513
MEDICARE ID
ID
05
—
1790881514
—
MT
01
—
410045546
RAILROAD MEDICARE
WA
05
—
80810904
—
ID
01
—
G8889165
MEDICARE WA
WA
01
—
G8889166
MEDICARE WA
WA
01
—
G8889167
MEDICARE WA
WA
01
—
G8889168
MEDICARE WA
WA
01
—
G8889169
MEDICARE WA
WA
01
—
M011000850
MEDICARE MT
MT
Enumeration date
09/16/2006
Last updated
11/19/2020
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