NPIMap

Organization Active NPI

Hollingbery Physical Therapy

  • Physical Therapist
  • Lacey, WA
National Provider Identifier
1215020623
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
HOLLINGBERY PHYSICAL THERAPY
Practice address
669 Woodland Square Loop SE
Suite C
Lacey, WA 98503-1038
Phone
(360) 923-5323
Fax
(360) 923-5531
NPI assigned
Sep 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Diana Hollingbery, PTNPI 1295828606
Title
Manageing Partner
Phone
(360) 923-5323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X WA Primary

Addresses

Primary practice location

669 Woodland Square Loop SE
Suite C
Lacey, WA 98503-1038

Mailing address

669 Woodland Square Loop SE
Suite C
Lacey, WA 98503-1038
Phone (360) 923-5323

Other identifiers 2

IdentifierTypeStateIssuer
0166363OtherWALABOR & INDUSTRY NUMBER
7117864MedicaidWA

National Provider Directory

National Provider Directory

Locations

669 Woodland Square Loop SE
Ste C
Lacey, WA 98503
Phone (360) 923-5323

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215020623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 WOODLAND SQUARE LOOP SE",
            "address_2": "SUITE C",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031038",
            "telephone_number": "360-923-5323",
            "fax_number": "360-923-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 WOODLAND SQUARE LOOP SE",
            "address_2": "SUITE C",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031038",
            "telephone_number": "360-923-5323",
            "fax_number": "360-923-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLINGBERY PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLINGBERY",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "MANAGEING PARTNER",
        "authorized_official_telephone_number": "360-923-5323",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY NUMBER",
            "identifier": "0166363",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7117864",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.