Individual
MARY T. BOLLES-HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, ARNP
Contact information
Practice address
10330 MERIDIAN AVE N, SUITE 190, SEATTLE, WA 98133-9451
(206) 368-6670
(206) 368-6171
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00089718
WA
363L00000X
Nurse Practitioner
AP30006303
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61434065
WA
367A00000X
Advanced Practice Midwife
AP30006303
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962427658
—
WA
01
—
56102U
REGENCE BLUESHIELD
WA
05
—
9639014
—
WA
Enumeration date
07/13/2006
Last updated
08/02/2024
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