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

Holly Lickwala, PT

Individual provider Physical Therapist · NPI 1699912295

Holly Lickwala, PT is a Physical Therapist in Private Practice in Centralia, Washington. Qualified in 2003, 23 years ago. Practices with Washington Luna Care Physical Therapy LLC, a 162-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona and Washington.

Years since qualifying
23
Licensed in
AZ, WA
In the registry since
2009
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1118 View Ave
Centralia, WA 98531-1870
Phone: (360) 736-8273
Fax: (360) 736-5053
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1817 S Market Blvd Ste C, Chehalis, WA 98532-4100 — (360) 996-4410

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT60272758 (WA)
Physical Therapist Taxonomy 225100000X · Licence 6214 (AZ)

Record details

NPI number1699912295
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedJanuary 19, 2009
Last updated in NPPESAugust 21, 2020
Certification dateAugust 21, 2020

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Washington Luna Care Physical Therapy Llc — 162 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Centralia