Active NPI
Wade Allen Holden, P.A.
- Medical Physician Assistant
- Yakima, WA
National Provider Identifier
1538463252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 3909 Creekside Loop Ste 115
Yakima, WA 98902-4880 - Phone
- (509) 574-6095
- Fax
- (509) 574-6098
- NPI assigned
- Jan 10, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 646 | MT | |
| Medical Physician Assistant | 363AM0700X | WA | Primary |
Addresses
Primary practice location
3909 Creekside Loop Ste 115
Yakima, WA 98902-4880
Mailing address
3800 Summitview Ave
Yakima, WA 98902-2715
Phone (509) 248-7849
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 646 | Other | MT | STATE LICENSE |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 646 | MT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1538463252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 SUMMITVIEW AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989022715",
"telephone_number": "509-248-7849",
"fax_number": "509-248-8291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3909 CREEKSIDE LOOP STE 115",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989024880",
"telephone_number": "509-574-6095",
"fax_number": "509-574-6098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLDEN",
"first_name": "WADE",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-10",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MT",
"license": "646",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "646",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.