Provider Demographics
NPI:1609938695
Name:HOLMES, LISA B (RN FIRST ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:B
Last Name:HOLMES
Suffix:
Gender:F
Credentials:RN FIRST ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2366
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98907-2366
Mailing Address - Country:US
Mailing Address - Phone:509-945-5259
Mailing Address - Fax:509-577-0147
Practice Address - Street 1:110 S 9TH AVE
Practice Address - Street 2:YAKIMA REGIONAL MEDICAL CENTER
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:509-945-5259
Practice Address - Fax:509-577-0147
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00146394163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6615HOOtherREGENCE
WA185603OtherL & I