Provider Demographics
NPI:1679196356
Name:DR. CRANE HOLMES, LLC
Entity Type:Organization
Organization Name:DR. CRANE HOLMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:570-212-1219
Mailing Address - Street 1:6547 NE GRAND AVE APT B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-3081
Mailing Address - Country:US
Mailing Address - Phone:570-212-1219
Mailing Address - Fax:
Practice Address - Street 1:2115 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1522
Practice Address - Country:US
Practice Address - Phone:971-266-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty