Provider Demographics
NPI:1689726754
Name:HAMILTON, HOLLY H (DPT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:H
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 HENDRYX RD
Mailing Address - Street 2:
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672-8743
Mailing Address - Country:US
Mailing Address - Phone:503-330-2848
Mailing Address - Fax:360-859-4639
Practice Address - Street 1:251 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-1150
Practice Address - Country:US
Practice Address - Phone:503-330-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60099668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist