Provider Demographics
NPI:1023425576
Name:HOLMAN, MICHAEL FOSTER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FOSTER
Last Name:HOLMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 TURNER RD SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-2003
Mailing Address - Country:US
Mailing Address - Phone:503-391-0586
Mailing Address - Fax:503-391-0753
Practice Address - Street 1:1940 TURNER RD SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-2003
Practice Address - Country:US
Practice Address - Phone:503-391-0586
Practice Address - Fax:503-391-0753
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0010471183500000X
WAPH 00052736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH 00052736OtherWASHINGTON STATE BOARD OF PHARMACY
ORRPH-0010471OtherOREGON BOARD OF PHARMACY