Provider Demographics
NPI:1710586326
Name:HOLTSBERRY, CATHARINA
Entity type:Individual
Prefix:
First Name:CATHARINA
Middle Name:
Last Name:HOLTSBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8116 HIDDEN VALLEY DR SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1907
Mailing Address - Country:US
Mailing Address - Phone:360-438-1817
Mailing Address - Fax:
Practice Address - Street 1:8116 HIDDEN VALLEY DR SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98503-1907
Practice Address - Country:US
Practice Address - Phone:360-438-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC7634171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter