Active NPI
Edward Holyoke, D.C.
- Sports Physician Chiropractor
- Clarkston, WA
National Provider Identifier
1881708980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- WA780
- Practice address
- 733 5TH St
Suite E
Clarkston, WA 99403-2671 - Phone
- (509) 758-7258
- Fax
- (509) 758-7258
- NPI assigned
- Aug 18, 2006
- Last updated
- Jul 21, 2022
- 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 |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | WA780 | WA | Primary |
Addresses
Primary practice location
733 5TH St
Suite E
Clarkston, WA 99403-2671
Mailing address
733 5TH St
Suite E
Clarkston, WA 99403-2671
Phone (509) 758-7258
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010007133 | Other | WA | REGENCE BLUE SHIELD |
| C9768 | Other | WA | BLUE CROSS OF IDAHO |
| 780 | Other | WA | WA STATE LICENSE NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WA780 | WA | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1881708980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "733 5TH ST",
"address_2": "SUITE E",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994032671",
"telephone_number": "509-758-7258",
"fax_number": "509-758-7258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "733 5TH ST",
"address_2": "SUITE E",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994032671",
"telephone_number": "509-758-7258",
"fax_number": "509-758-7258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLYOKE",
"first_name": "EDWARD",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "WA",
"license": "WA780",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "000010007133",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "C9768",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA STATE LICENSE NUMBER",
"identifier": "780",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarkston, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.