Kathleen Holloway, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10004276 Issued in WA

Practice address

220 Nat Washington Way
Ephrata, WA 98823

Phone

(509) 754-3330

Fax

(509) 754-2351

NPI assigned

Sep 26, 2006

Last updated

May 21, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wenatchee Valley Hospital

  • Multi-Specialty Clinic/Center
  • Wenatchee, WA
  • NPI 1669719688
  Medicare reassignment NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1902907470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 NAT WASHINGTON WAY",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988231982",
            "telephone_number": "509-754-3330",
            "fax_number": "509-754-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 NAT WASHINGTON WAY",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "98823",
            "telephone_number": "509-754-3330",
            "fax_number": "509-754-2351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 S Pioneer Way Suite 115",
            "address_2": "Samaritan Clinic",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "98837",
            "country_code": "US",
            "telephone_number": "509-793-9790",
            "fax_number": "509-764-3255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902907470",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01110206",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0301659",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avery E. Harrison, DDS
• August Samuel Hein, MD
• Karen Hernandez
• Stephanie Hesse, O.D.
• Christy Hill, L.M.P.
• Kayla Rae Huber
• Yoon Jea Im
• Brian James Jacobsen, D.M.D.
• Poonam Kalsi
• Eve Keen, LMP

• Medical Physician Assistant in Ephrata, WA
• Providers in Ephrata, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.