Provider Demographics
NPI:1427933381
Name:EASTSIDE ELECTROLOGY
Entity type:Organization
Organization Name:EASTSIDE ELECTROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANGEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLUB
Authorized Official - Suffix:
Authorized Official - Credentials:LE, CPE
Authorized Official - Phone:503-539-9953
Mailing Address - Street 1:1635 SE MALDEN ST STE B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6065
Mailing Address - Country:US
Mailing Address - Phone:503-593-2141
Mailing Address - Fax:
Practice Address - Street 1:1635 SE MALDEN ST STE B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6065
Practice Address - Country:US
Practice Address - Phone:503-593-2141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-09
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty