Healthcare Provider Details

I. General information

NPI: 1316381718
Provider Name (Legal Business Name): MICHAEL GEORGE HOLMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-6540
US

IV. Provider business mailing address

1229 MADISON ST STE 1440
SEATTLE WA
98104-3538
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-2470
  • Fax:
Mailing address:
  • Phone: 206-625-0578
  • Fax: 206-625-9184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberML60380367
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberMD60868964
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: