Individual provider Active NPI

Justin Wayne Holt, MD

  • Otolaryngology Physician
  • Astoria, OR
National Provider Identifier
1902225709
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD194072 Issued in OR
Practice address
2055 Exchange St Ste 210
Astoria, OR 97103-3419
Phone
(503) 338-4517
Fax
(503) 338-4521
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD194072 OR Primary

Addresses

Primary practice location

2055 Exchange St Ste 210
Astoria, OR 97103-3419

Mailing address

2111 Exchange St
Astoria, OR 97103-3329
Phone (503) 325-4321

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191113000833 WA Practitioner - Otolaryngology 9133346778 Reassigns benefits to 1 organization
I20200115000983 OR Practitioner - Otolaryngology 9133346778 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD194072ORMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center CurrentSince Aug 1, 2022 Accepting new patients
Columbia Lutheran Charities Otolaryngology CurrentSince May 1, 2025 Accepting new patients
Mid-Columbia Medical Center CurrentSince Aug 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 9, 2019 Accepting new patients
Columbia Lutheran Charities Current Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 9, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 9, 2019 Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

2055 Exchange St
Ste 210
Astoria, OR 97103
Phone (503) 325-3935

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1810 E 19th St
Ste 211
The Dalles, OR 97058
Phone (503) 292-1400

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

551 Lone Pine Blvd
Ste 200B
The Dalles, OR 97058
Phone (541) 298-5563

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1902225709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 EXCHANGE ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033329",
            "telephone_number": "503-325-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 EXCHANGE ST STE 210",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033419",
            "telephone_number": "503-338-4517",
            "fax_number": "503-338-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "JUSTIN",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD194072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.