Provider Demographics
NPI:1699029256
Name:HOLMAN, HELIX CAMRYN
Entity Type:Individual
Prefix:
First Name:HELIX
Middle Name:CAMRYN
Last Name:HOLMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8625 N LEONARD ST
Mailing Address - Street 2:APT 2
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-3740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7621 N PORTSMOUTH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-5953
Practice Address - Country:US
Practice Address - Phone:503-240-7599
Practice Address - Fax:503-240-8066
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion