Holly Lickwala, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60272758 Issued in WA

Practice address

1118 View Ave
Centralia, WA 98531-1870

Phone

(360) 736-8273

Fax

(360) 736-5053

NPI assigned

Jan 19, 2009

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

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington Luna Care Physical Therapy LLCGroup PAC ID 7416283817, 161 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Washington Luna Care Physical Therapy LLC

  • Physical Therapist
  • Bellevue, WA
  • NPI 1346808052
  Medicare reassignment Care Compare group NPD
• Grays Harbor County Public Hospital District No 1

  dba Summit Pacific Medical Center

  • Critical Access Hospital
  • Elma, WA
  • NPI 1740211028
  Medicare reassignment NPD
• King County Public Hospital District No 2

  dba Booth Gardner Parkinsons Care Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment NPD
• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724
  Medicare reassignment NPD
• Grays Harbor County Public Hospital District No 1

  dba Summit Pacific Health Clinic

  • Rural Health Clinic/Center
  • Elma, WA
  • NPI 1083202907
  NPD
• King County Public Hospital District No. 2

  dba EvergreenHealth at Home Physical Therapy

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• Swedish Health Services

  • Physical Therapist
  • Seattle, WA
  • NPI 1619680840
  NPD
• Aeroflow Connect LLC

  dba Lactation Link

  • Lactation Consultant (Non-RN)
  • Asheville, NC
  • NPI 1790306819
  NPD (past)
• Vitality Physical Therapy and Wellness, Inc

  • Physical Therapist
  • Gold Canyon, AZ
  • NPI 1316970437
  NPD (past)

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

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1699912295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 VIEW AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311870",
            "telephone_number": "360-736-8273",
            "fax_number": "360-736-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 VIEW AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311870",
            "telephone_number": "360-736-8273",
            "fax_number": "360-736-5053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1817 S Market Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Chehalis",
            "state": "WA",
            "postal_code": "985324100",
            "country_code": "US",
            "telephone_number": "360-996-4410",
            "fax_number": "360-996-4466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICKWALA",
        "first_name": "HOLLY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-19",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6214",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60272758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lewis County Community Health Services (Valley View Health Center - Centralia)
• Lewis County Community Health Services (Valley View Health Center Pharmacy #003)
• Lewis County Emergency Physicians
• Lewis County Therapy Services, LLC
• Lewis County Vision Source PC (Dr. Kelly Padgett)
• Sophia Michelle Limacher
• Kevin Chase Lindahl, MA
• Morgan Robbins Lindbergh
• Renee Lindgren, CPNP
• Lisa Jimenez Pmhnp PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.