Provider Demographics
NPI:1558588723
Name:CHRISTY, HOLLY MICHAEL (ND, LAEMP)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:MICHAEL
Last Name:CHRISTY
Suffix:
Gender:F
Credentials:ND, LAEMP
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:MICHAEL
Other - Last Name:CHRISTY-MARICIELO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND, LAC
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-0333
Mailing Address - Country:US
Mailing Address - Phone:206-780-0402
Mailing Address - Fax:206-780-0465
Practice Address - Street 1:19041 FRONT ST NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7354
Practice Address - Country:US
Practice Address - Phone:206-780-0402
Practice Address - Fax:206-780-0465
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00001819171100000X
WANT00000997175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist