Provider Demographics
NPI:1477172922
Name:HOLMMADE NUTRITION, LLC
Entity Type:Organization
Organization Name:HOLMMADE NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CD, CLC
Authorized Official - Phone:509-205-1018
Mailing Address - Street 1:28806 S 887 PR SE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338
Mailing Address - Country:US
Mailing Address - Phone:509-205-1018
Mailing Address - Fax:
Practice Address - Street 1:28806 S 887 PR SE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338
Practice Address - Country:US
Practice Address - Phone:509-205-1018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare