Provider Demographics
NPI:1912270943
Name:HOLLYMAN-PITKANEN, DORIS ANN (CPHT)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:ANN
Last Name:HOLLYMAN-PITKANEN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 WILLAKENZIE ROAD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-687-7613
Mailing Address - Fax:541-687-7616
Practice Address - Street 1:2410 WILLAKENZIE ROAD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-687-7613
Practice Address - Fax:541-687-7616
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR330100105111146247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other