Provider Demographics
NPI:1033677596
Name:HOLLAND, ERICA ANN (LAC, EAMP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:ANN
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LAC, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14610 NE 186TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRUSH PRAIRIE
Mailing Address - State:WA
Mailing Address - Zip Code:98606-5105
Mailing Address - Country:US
Mailing Address - Phone:360-909-6065
Mailing Address - Fax:
Practice Address - Street 1:14610 NE 186TH AVE
Practice Address - Street 2:
Practice Address - City:BRUSH PRAIRIE
Practice Address - State:WA
Practice Address - Zip Code:98606-5105
Practice Address - Country:US
Practice Address - Phone:360-909-6065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60932010171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist