Provider Demographics
NPI:1760130702
Name:HOLTEN, ASHLEY ANNE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANNE
Last Name:HOLTEN
Suffix:
Gender:F
Credentials:
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 761
Mailing Address - Street 2:
Mailing Address - City:JOSEPH
Mailing Address - State:OR
Mailing Address - Zip Code:97846-0761
Mailing Address - Country:US
Mailing Address - Phone:541-870-8489
Mailing Address - Fax:
Practice Address - Street 1:606 MEDICAL PARKWAY
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:OR
Practice Address - Zip Code:97828
Practice Address - Country:US
Practice Address - Phone:541-426-4524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator