Provider Demographics
NPI:1396466918
Name:HOLMLY, ALEXA E
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:E
Last Name:HOLMLY
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 727
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-0727
Mailing Address - Country:US
Mailing Address - Phone:360-331-0141
Mailing Address - Fax:360-331-0142
Practice Address - Street 1:5575 HARBOR AVE STE 103
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249-3007
Practice Address - Country:US
Practice Address - Phone:360-331-0141
Practice Address - Fax:360-331-0142
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist