Individual
NATHANIEL HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8935 SE POWELL BLVD, PORTLAND, OR 97266-1938
(503) 772-4335
(503) 772-4337
Mailing address
8935 SE POWELL BLVD, PORTLAND, OR 97266-1938
(503) 772-4335
(503) 772-4337
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201150076NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168395
—
OR
05
—
1851670954
—
WA
05
—
500687152
—
OR
01
—
R181308
MEDICARE
OR
Enumeration date
08/08/2011
Last updated
03/18/2021
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