Liberatore, Holly C

Liberatore, Holly C is an individual health care provider with primary practice located at 1615 Delaware St , Longview WA 98632-2310. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Liberatore, Holly C can be contacted via phone (360) 414-2000.

Contact Information

Primary practice address
1615 Delaware St Longview WA 98632-2310
Phone: (360) 414-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 23705 Mississippi
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD00042244 Washington

Profile Details

NPI number 1811928625
LBN Legal business name Liberatore, Holly C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated May 27th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811928625 NPPES
Mississippi MEDICAID 05483727
Mississippi MEDICAID 8351926

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