Mark A Bollinger

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P161319332 Issued in WA

Practice address

3252 NE 3Rd Ave Ste 2
Camas, WA 98607-2448

Phone

(360) 835-7427

NPI assigned

Feb 13, 2024

Last updated

Feb 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Camas Physical Therapy

  • Physical Therapist
  • Camas, WA
  • NPI 1598977175
  NPD

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1992569529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 W 16TH ST APT B",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3252 NE 3RD AVE STE 2",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072448",
            "telephone_number": "360-835-7427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLINGER",
        "first_name": "MARK",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P161319332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria N Bloomfield, LMHC
• Blossom Natural Health and Wellness
• Bluestream Counseling LLC
• Body Balance Health and Aesthetics Medicine
• Kevin Pharis Bohn
• Olga Boltenkov, LICSW
• Brittany Nicole Bonner-Dillon, PSY.D.
• Chelsea Easton Brandenburg, M.ED
• Richard Paul Braskett
• Constance Joy Brester, DDS

• Physical Therapy Assistant in Camas, WA
• Providers in Camas, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.

Verify at the official NPI Registry.