Provider Demographics
NPI:1588200349
Name:HOLLERAN, JOANNA (DC)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:HOLLERAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 148TH AVE NE APT A3002
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6535
Mailing Address - Country:US
Mailing Address - Phone:610-883-6627
Mailing Address - Fax:
Practice Address - Street 1:17523 NE 67TH CT
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4939
Practice Address - Country:US
Practice Address - Phone:425-245-0667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61013391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor