Healthcare Provider Details

I. General information

NPI: 1073043899
Provider Name (Legal Business Name): EMILY ANN HOLMES MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY ANN PRAUSE

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PACIFIC AVE STE 130
EVERETT WA
98201-4188
US

IV. Provider business mailing address

900 PACIFIC AVE STE 130
EVERETT WA
98201-4188
US

V. Phone/Fax

Practice location:
  • Phone: 425-258-7657
  • Fax: 425-258-7618
Mailing address:
  • Phone: 425-258-7657
  • Fax: 425-258-7618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLL61342648
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22006317A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: