Provider Demographics
NPI:1740330372
Name:HOLDER, CURTIS H (MD)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:H
Last Name:HOLDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 6TH ST STE 230
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98337-1439
Mailing Address - Country:US
Mailing Address - Phone:360-479-5959
Mailing Address - Fax:360-373-6355
Practice Address - Street 1:843 6TH ST STE 230
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98337-1439
Practice Address - Country:US
Practice Address - Phone:360-479-5959
Practice Address - Fax:360-373-6355
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000356812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB03057Medicare ID - Type Unspecified
WAG64480Medicare UPIN