Provider Demographics
NPI:1356613962
Name:HORNE, HOWARD
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:HORNE
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:PO BOX 1343
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95024-1343
Mailing Address - Country:US
Mailing Address - Phone:888-948-1110
Mailing Address - Fax:888-948-1110
Practice Address - Street 1:23842 SE 246TH ST
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-8356
Practice Address - Country:US
Practice Address - Phone:888-948-1110
Practice Address - Fax:888-948-1110
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor