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General NPI Number Information
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NPI Number | 1558243493
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Entity Type | Organization
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Legal Business Name | INNERLIGHT WELLNESS P.L.L.C
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 2310 N MOLTER RD STE 206 SUITE 206
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-8621
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Country | US
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Telephone | 509-289-4969
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Fax | 509-289-4968
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Provider Business Mailing Address
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Address Line | 2310 N MOLTER RD STE 206
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-8621
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Country | US
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Telephone | 509-289-4969
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Fax | 509-289-4968
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Authorized Official
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Title or Position | OWNER
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Name | HEIDI J COOPER
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Credential | MSN, APRN, CPNP-PC,
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Telephone | 208-661-5991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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