Provider Demographics
NPI:1346651882
Name:MATTHEWS, HOLLY MARIE
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARIE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MARIE
Other - Last Name:KLOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:788 SAINT CHARLES PL
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-8785
Mailing Address - Country:US
Mailing Address - Phone:509-637-4484
Mailing Address - Fax:
Practice Address - Street 1:788 SAINT CHARLES PL
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-8785
Practice Address - Country:US
Practice Address - Phone:509-637-4484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201390556RN163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health