Healthcare Provider Details

I. General information

NPI: 1891005179
Provider Name (Legal Business Name): WHOLEY HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8817 E MISSION AVE STE 106
SPOKANE VALLEY WA
99212-5034
US

IV. Provider business mailing address

8817 E MISSION AVE STE 106
SPOKANE VALLEY WA
99212-5034
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-0597
  • Fax: 509-474-9857
Mailing address:
  • Phone: 509-474-0597
  • Fax: 509-474-9857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberNT00001500
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30007639
License Number StateWA

VIII. Authorized Official

Name: DR. PHILIP WILLIAM FALER
Title or Position: PRESIDENT
Credential: N.D.
Phone: 509-474-0597