Individual
CYNTHIA LOUISE HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1890 WAITE ST, SUITE 1, NORTH BEND, OR 97459-1229
(541) 756-6232
(541) 756-6234
Mailing address
1890 WAITE ST, SUITE 1, NORTH BEND, OR 97459-1229
(541) 756-6232
(541) 756-6234
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01102
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619915113
WATERFALL CLINIC, INC. GROUP NPI
—
05
—
213342
—
OR
01
—
381902
FQHC MEDICARE NUMBER
—
Enumeration date
05/12/2006
Last updated
08/21/2013
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