Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Holly Brock, PA

Individual provider Physician Assistant · NPI 1023249810

Holly Brock, PA is a Physician Assistant in Vancouver, Washington. Qualified in 2010, 16 years ago. Practices as a sole proprietor. Licensed in Washington.

Years since qualifying
16
Licensed in
WA
In the registry since
2009
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1400 NE 136th Ave Ste 201
Vancouver, WA 98684-0993
Phone: (360) 258-1787
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 61433590 (WA)

Record details

NPI number1023249810
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJuly 28, 2009
Last updated in NPPESApril 3, 2025
Certification dateApril 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Accepts Medicare assignment Not indicated

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