MEDICARE: DR. DAVIN HOLLAND PSY 60980939

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY60980939	WA

General Provider Information

NPI Number	:	1740003201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVIN HOLLAND PSY 60980939

Provider Business Mailing Address
First Line	:	710 ERICKSEN AVE NE STE 100
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-2835
Country	:	US
Telephone Number	:	360-230-8141
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 ERICKSEN AVE NE STE 100
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-2835
Country	:	US
Telephone Number	:	360-230-8141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	11/05/2024

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