Provider Demographics
NPI:1578774360
Name:HEALING CENTER INC.
Entity Type:Organization
Organization Name:HEALING CENTER INC.
Other - Org Name:FOURTH AVE CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-624-5855
Mailing Address - Street 1:1625 W 4TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-5620
Mailing Address - Country:US
Mailing Address - Phone:509-624-5855
Mailing Address - Fax:509-838-5779
Practice Address - Street 1:1625 W 4TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-5620
Practice Address - Country:US
Practice Address - Phone:509-624-5855
Practice Address - Fax:509-838-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAL0705495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA319214200Medicare ID - Type Unspecified
WAU27322Medicare UPIN