Provider Demographics
NPI:1376322834
Name:HOLMES, TANNER JEFFREY (DC)
Entity Type:Individual
Prefix:
First Name:TANNER
Middle Name:JEFFREY
Last Name:HOLMES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5775 SOUNDVIEW DR STE A103
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-2090
Mailing Address - Country:US
Mailing Address - Phone:360-728-6795
Mailing Address - Fax:
Practice Address - Street 1:5775 SOUNDVIEW DR STE A103
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-2090
Practice Address - Country:US
Practice Address - Phone:360-728-6795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61482082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor