Provider Demographics
NPI:1619200227
Name:HILL, JUDY COLLEEN
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:COLLEEN
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NE PARK PLAZA DR
Mailing Address - Street 2:SUITE 246
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5808
Mailing Address - Country:US
Mailing Address - Phone:360-696-1070
Mailing Address - Fax:360-737-0200
Practice Address - Street 1:201 NE PARK PLAZA DR
Practice Address - Street 2:SUITE 246
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5808
Practice Address - Country:US
Practice Address - Phone:360-696-1070
Practice Address - Fax:360-737-0200
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR07311208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation