Edward Ericson Holden, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00610 Issued in OR

Practice address

600 NE 92ND Ave
Vancouver, WA 98664-3225

Phone

(360) 514-2142

Fax

(360) 514-6820

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eholden7191@samhealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Medicare reassignment NPD
• Public Hospital District No 2, Klickitat County Washington

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1952483653
  Medicare reassignment NPD
• Public Hospital District No. 2, Klickitat County, Washington

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1760455687
  Medicare reassignment NPD
• Columbia Lutheran Charities

  • Critical Access Hospital
  • Astoria, OR
  • NPI 1134146939
  Medicare reassignment NPD
• Columbia Lutheran Charities

  • Surgery Physician
  • Astoria, OR
  • NPI 1821254129
  Medicare reassignment NPD
• Klickitat County Public Hospital District No 1

  • Clinic/Center
  • Goldendale, WA
  • NPI 1467530915
  Medicare reassignment
• Samaritan Pacific Health Services, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Newport, OR
  • NPI 1174888010
  Medicare reassignment
• Klickitat County Public Hospital District No 1

  • Emergency Care Clinic/Center
  • Goldendale, WA
  • NPI 1780754507
  NPD
• Columbia Lutheran Charities

  • Community/Retail Pharmacy
  • Astoria, OR
  • NPI 1093003667
  NPD
• Samaritan Pacific Health Services, Inc

  • Rural Health Clinic/Center
  • Depoe Bay, OR
  • NPI 1164781142
  NPD
• Samaritan Pacific Health Services, Inc.

  • Internal Medicine Physician
  • Newport, OR
  • NPI 1336574912
  NPD
• Columbia Lutheran Charities

  • Community Based Hospice Care Agency
  • Astoria, OR
  • NPI 1023038858
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1053368340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1600",
            "address_2": "UNIT 282",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986681600",
            "telephone_number": "360-514-2142",
            "fax_number": "360-514-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE 92ND AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643225",
            "telephone_number": "360-514-2142",
            "fax_number": "360-514-6820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 SW Abbey St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "OR",
            "postal_code": "973654820",
            "country_code": "US",
            "telephone_number": "541-265-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "EDWARD",
        "middle_name": "ERICSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004163",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8357949",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eholden7191@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Holly P Holborn, LMT
• Hailey Holbrook
• Lisa Kay Holbrook, MD
• Joy Holcomb, LMP
• Allen W Holden, LMP
• Kathleen Marie Holder
• Lea Ann Holder, LICSW
• Trisha Holder, NP
• Ellery Holesapple, CDPT
• Donna M Holland, CDPT

• Physician Assistant in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.