Provider Demographics
NPI:1134404098
Name:HOLMAN, JOAN DONOVAN (MD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:DONOVAN
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 2ND AVE STE 3200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3800
Mailing Address - Country:US
Mailing Address - Phone:206-219-7811
Mailing Address - Fax:
Practice Address - Street 1:1301 2ND AVE STE 3200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3800
Practice Address - Country:US
Practice Address - Phone:206-219-7811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine