Holladay & Associates, PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

156792 Issued in OR

Legal business name

HOLLADAY & ASSOCIATES, PC

Practice address

1717 NE 42ND Ave
Suite 2104
Portland, OR 97213-1569

Phone

(503) 477-4969

NPI assigned

Jul 27, 2015

Organization subpart

No

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

Authorized official

Name

Kenneth David Holladay, M.D.

Title

Medical Director

Phone

(503) 477-4969

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437955200000",
    "number": "1730564139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 NE 42ND AVENUE",
            "address_2": "SUITE 2104",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131570",
            "telephone_number": "503-477-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 NE 42ND AVE",
            "address_2": "SUITE 2104",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131569",
            "telephone_number": "503-477-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLADAY & ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A",
        "authorized_official_last_name": "HOLLADAY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "503-477-4969",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OR",
            "license": "156792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holistic Mental Health, LLC
• Holistic Treatment Center & Spa
• Holistic Virtual Services
• Holistic Well Nursing Corp
• Shelli F Holk, R.N.
• Holladay Park Plaza, Inc
• Kenneth David Holladay, M.D.
• Alisha Holland
• Angela Dawn Holland, B.S., QMHA
• Ann Marie Holland, N.D., MSOM, L. AC.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.