Active NPI
Harley Steven Holliday, LMP
- Specialist
- Eatonville, WA
National Provider Identifier
1306054465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00022087
- Practice address
- 31218 Webster Rd E
Eatonville, WA 98328-8674 - Phone
- (253) 847-8728
- NPI assigned
- May 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00022087 | WA | Primary |
Addresses
Primary practice location
31218 Webster Rd E
Eatonville, WA 98328-8674
Mailing address
31218 Webster Rd E
Eatonville, WA 98328-8674
Phone (253) 847-8728
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00022087 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306054465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31218 WEBSTER RD E",
"city": "EATONVILLE",
"state": "WA",
"postal_code": "983288674",
"telephone_number": "253-847-8728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31218 WEBSTER RD E",
"city": "EATONVILLE",
"state": "WA",
"postal_code": "983288674",
"telephone_number": "253-847-8728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIDAY",
"first_name": "HARLEY",
"middle_name": "STEVEN",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00022087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eatonville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.