Provider Demographics
NPI:1588034409
Name:HOUSE OF HEALING
Entity Type:Organization
Organization Name:HOUSE OF HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-805-8005
Mailing Address - Street 1:7 S HOWARD ST
Mailing Address - Street 2:STE 210
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-3821
Mailing Address - Country:US
Mailing Address - Phone:509-979-5089
Mailing Address - Fax:
Practice Address - Street 1:7 S HOWARD ST
Practice Address - Street 2:STE 210
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3821
Practice Address - Country:US
Practice Address - Phone:509-979-5089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1041C0700X, 207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty