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General NPI Number Information
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NPI Number | 1215718457
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Entity Type | Organization
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Legal Business Name | INTEGRA HEALTH AND WELLNESS PLLC
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 16201 E INDIANA AVE STE 2260
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-2838
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Country | US
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Telephone | 509-970-5750
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Fax |
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Provider Business Mailing Address
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Address Line | 17820 E GALAXY CT
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City | GREENACRES
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State | WA
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Zip | 99016-7792
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Country | US
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Telephone | 509-970-5750
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PUSHAPDEEP BRAR
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Credential | MD
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Telephone | 550-997-0575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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