HOLLY RIDGE CENTER NPI 1861549206

NPI Information

  • NPI: 1861549206
  • Provider Name: HOLLY RIDGE CENTER
  • Classification: Physical Therapist - 2251P0200X
  • Specialization: Pediatrics
  • Entity Type: Organization
  • Address: 5112 NW TAYLOR RD
    BREMERTON, WA
    ZIP 98312
  • Phone: (360) 373-2536

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NPI Details

HOLLY RIDGE CENTER is a pediatrics physical therapist in Bremerton, WA. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given. HOLLY RIDGE CENTER NPI is 1861549206. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5112 NW TAYLOR RD
BREMERTON, WA
ZIP 98312-837
Phone: (360) 373-2536
Fax: (360) 373-4934

The provider's authorized official is Roxanne Bryson .
The authorized official title is Executive Director and has the following contact phone number (360) 373-2536.

The enumeration date for this NPI number is 1/5/2007 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC2200XPsychologistClinical Child & AdolescentNo
2104100000XSocial WorkerNo
32080P0006XPediatricsDevelopmental - Behavioral PediatricsNo
4235Z00000XSpeech-Language PathologistNo
5364S00000XClinical Nurse SpecialistNo
6225XP0200XOccupational TherapistPediatricsNo
72251P0200XPhysical TherapistPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17007271MEDICAIDWASHINGTON
27017742MEDICAIDWASHINGTON
37660228MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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