| Doctor Name: | HOLLY BALSBAUGH |
| NPI Number: | 1710082532 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 200650084NP |
| Business Practice Address: | 51377 Sw Old Portland Rd Ste C Scappoose, OR - 970564023 |
| Business Phone Number: | 5035433181 |
| Business Fax Number: | |
| Mailing Address: | 875 Ne Simpson St, PORTLAND |
| State: | OR |
| Postal Code: | 972113748 |
| Phone Number: | 5032343172 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2006 |
| NPI Last Update Date: | 01/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 200650084NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |