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General NPI Number Information
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NPI Number | 1821594896
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Entity Type | Organization
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Legal Business Name | HEALING THERAPY NORTHWEST
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 1727 E FRANCIS AVE STE 2
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City | SPOKANE
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State | WA
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Zip | 99208-2749
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Country | US
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Telephone | 509-844-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 118 W REGINA AVE
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City | SPOKANE
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State | WA
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Zip | 99218-1947
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Country | US
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Telephone | 509-844-7700
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST/OWNER
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Name | STEPHEN EMERY WELLS
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Credential | LMT IOP
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Telephone | 509-844-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 60421190909
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License Number State | WA
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