Holly N. Tipp, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP004609T Issued in WA

Practice address

501 SE 172ND Ave Ste 110
Vancouver, WA 98684-9542

Phone

(360) 882-2778

Fax

(360) 604-1773

NPI assigned

Sep 10, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Vancouver Clinic Inc PS

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment NPD
• The Vancouver Clinic Inc PS

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1073096723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE 172ND AVE STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986849542",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 SW Morrison St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972051916",
            "country_code": "US",
            "telephone_number": "503-227-7774",
            "fax_number": "503-227-7548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIPP",
        "first_name": "HOLLY",
        "middle_name": "N.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62983",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "CP004609T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OREGON",
            "identifier": "62983",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moon V Tinajero-Simmaly, PA-C
• Michelle Tinajero
• Andrea Lynn Tindal
• Amanda M Tinkle, DMD
• Jennifer Tinsley, LCSW
• Annalisa Joy Tirado
• Richard Titterington, LMP, LMT
• Megan Alanna Titus
• Vasyl Tkachyk, DDS
• TLC Behavioral Consulting

• Physical Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.