Provider Demographics
NPI:1265498240
Name:ROOK, HOLLI LAINE (DPT)
Entity Type:Individual
Prefix:
First Name:HOLLI
Middle Name:LAINE
Last Name:ROOK
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 1:1306 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902
Mailing Address - Country:US
Mailing Address - Phone:509-833-3044
Mailing Address - Fax:
Practice Address - Street 1:5255 N GEORGE BUSH HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2778
Practice Address - Country:US
Practice Address - Phone:972-675-3609
Practice Address - Fax:972-675-3638
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009349225100000X
TX1203115225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA183320OtherLABOR & INDUSTRIES
WA8381642Medicaid
WA8801124Medicare ID - Type Unspecified