Provider Demographics
NPI:1790113140
Name:BALANZA HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:BALANZA HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:509-991-2962
Mailing Address - Street 1:701 W 7TH AVE
Mailing Address - Street 2:MARY CLIFF HALL SUITE 170
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2843
Mailing Address - Country:US
Mailing Address - Phone:509-991-2962
Mailing Address - Fax:509-747-0363
Practice Address - Street 1:701 W 7TH AVE
Practice Address - Street 2:MARY CLIFF HALL SUITE 170
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2843
Practice Address - Country:US
Practice Address - Phone:509-991-2962
Practice Address - Fax:509-747-0363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60101550225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty