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General NPI Number Information
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NPI Number | 1710126909
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Entity Type | Organization
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Legal Business Name | PACIFIC RHEUMATOLOGY ASSOCIATES INC PS
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 4300 TALBOT RD S SUITE 101
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City | RENTON
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State | WA
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Zip | 98055-6238
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Country | US
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Telephone | 425-235-9500
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Fax | 425-235-9555
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Provider Business Mailing Address
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Address Line | 4300 TALBOT RD S SUITE 101
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City | RENTON
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State | WA
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Zip | 98055-6238
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Country | US
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Telephone | 425-235-9500
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Fax | 425-235-9555
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ANDREW J HOLMAN
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Credential | M.D.
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Telephone | 425-235-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State | WA
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