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General NPI Number Information
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NPI Number | 1386983286
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Entity Type | Individual
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Provider Name | HOLLY FISH MD
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Gender | Female
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 401 15TH AVE SE
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City | PUYALLUP
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State | WA
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Zip | 98372-3715
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Country | US
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Telephone | 253-697-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 11404 65TH AVE
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City | GIG HARBOR
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State | WA
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Zip | 98332-8686
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 57467
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD61543808
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A120496
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License Number State | CA
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