Healthcare Provider Details

I. General information

NPI: 1821594896
Provider Name (Legal Business Name): HEALING THERAPY NORTHWEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 03/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 E FRANCIS AVE STE 2
SPOKANE WA
99208-2749
US

IV. Provider business mailing address

118 W REGINA AVE
SPOKANE WA
99218-1947
US

V. Phone/Fax

Practice location:
  • Phone: 509-844-7700
  • Fax:
Mailing address:
  • Phone: 509-844-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number60421190909
License Number StateWA

VIII. Authorized Official

Name: STEPHEN EMERY WELLS
Title or Position: MASSAGE THERAPIST/OWNER
Credential: LMT IOP
Phone: 509-844-7700