Active NPI
Colin Irvin Holganza Ortiz, PT
- Physical Therapist
- Ilwaco, WA
National Provider Identifier
1336987189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 61337277
- Practice address
- 316 1St Ave N
Ilwaco, WA 98624-9140 - Phone
- (360) 642-6328
- NPI assigned
- Jul 16, 2024
- Last updated
- Jul 16, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 61337277 | WA | Primary |
Addresses
Primary practice location
316 1St Ave N
Ilwaco, WA 98624-9140
Mailing address
PO Box 552
Ilwaco, WA 98624-0552
Phone (253) 386-0758
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61337277 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1336987189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 552",
"city": "ILWACO",
"state": "WA",
"postal_code": "986240552",
"telephone_number": "253-386-0758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 1ST AVE N",
"city": "ILWACO",
"state": "WA",
"postal_code": "986249140",
"telephone_number": "360-642-6328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "COLIN IRVIN",
"middle_name": "HOLGANZA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-16",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "61337277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ilwaco, WA
- Penny Irene Neal, LMP
- Ocean Beach Chiropractic
- Ocean Beach Chiropractic PS
- Ocean Beach Physical Therapy Inc
- Ocean Beach School District
- Jacob Owings, PHARMD
- Pacific Heart Associates PC
- Peninsula Pharmacies Inc (Ilwaco Pharmacy)
- Peninsula Pharmacies Inc. (Ilwaco Pharmacy)
- Providence Health & Services - Oregon (Providence Medical Group)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.