Provider Demographics
NPI:1558526905
Name:HOLLODI, GERGELY JENO (LMP)
Entity Type:Individual
Prefix:MR
First Name:GERGELY
Middle Name:JENO
Last Name:HOLLODI
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13233 156TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-2005
Mailing Address - Country:US
Mailing Address - Phone:425-861-6555
Mailing Address - Fax:
Practice Address - Street 1:13233 156TH AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-2005
Practice Address - Country:US
Practice Address - Phone:425-861-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60026921172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist