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General NPI Number Information
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NPI Number | 1164520565
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Entity Type | Organization
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Legal Business Name | CYNTHIA S HOLMES MD PC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1601 SE COURT AVE
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City | PENDLETON
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State | OR
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Zip | 97801-3217
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Country | US
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Telephone | 541-278-3228
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Fax | 541-278-3671
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Provider Business Mailing Address
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Address Line | PO BOX 1066
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City | CORVALLIS
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State | OR
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Zip | 97339-1066
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Country | US
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Telephone | 541-758-5047
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Fax | 541-758-3713
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Authorized Official
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Title or Position | PRESIDENT
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Name | CYNTHIA S HOLMES
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Credential | MD
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Telephone | 541-278-3228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 24138
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License Number State | OR
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