Provider Demographics
NPI:1881876498
Name:HOLLOWAY, KATHERINE WIX (MA)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:WIX
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7512 STANICH LN STE 5
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-5127
Mailing Address - Country:US
Mailing Address - Phone:253-318-6836
Mailing Address - Fax:
Practice Address - Street 1:7512 STANICH LN STE 5
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-5127
Practice Address - Country:US
Practice Address - Phone:253-318-6836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60125799106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist