Individual
CHAD ERIC HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO60709269
Contact information
Practice address
1616 S. GOLD ST. #4, CENTRALIA, WA 98531-0001
(360) 807-4929
(360) 807-4160
Mailing address
PO BOX 2394, LONGVIEW, WA 98632
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60709269
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60926712
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1991983
—
WA
05
—
2133639
—
WA
Enumeration date
06/15/2017
Last updated
10/30/2020
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