Individual
EDWARD HOLYOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
733 5TH ST, SUITE E, CLARKSTON, WA 99403-2671
(509) 758-7258
(509) 758-7258
Mailing address
733 5TH ST, SUITE E, CLARKSTON, WA 99403-2671
(509) 758-7258
(509) 758-7258
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
WA780
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010007133
REGENCE BLUE SHIELD
WA
01
—
780
WA STATE LICENSE NUMBER
WA
01
—
C9768
BLUE CROSS OF IDAHO
WA
Enumeration date
08/18/2006
Last updated
07/21/2022
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