Individual provider · Type 1 NPI
Kristy Holly, LPN
Adult Care Home Facility · Kelso, WA
NPI number
1023931672
Active
Practice location
205 Pelican Dr
Kelso, WA 98626-5811
Fax (360) 998-3420
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Care Home Facility Primary | 311ZA0620X | 753805 (WA) |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
About NPI 1023931672
Kristy Holly, LPN's National Provider Identifier is 1023931672, issued on Jul 31, 2026. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Kelso, WA. The record was last updated on Jul 31, 2026.