Provider Demographics
NPI:1821594896
Name:HEALING THERAPY NORTHWEST
Entity Type:Organization
Organization Name:HEALING THERAPY NORTHWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:EMERY
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT IOP
Authorized Official - Phone:509-844-7700
Mailing Address - Street 1:118 W REGINA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1947
Mailing Address - Country:US
Mailing Address - Phone:509-844-7700
Mailing Address - Fax:
Practice Address - Street 1:1727 E FRANCIS AVE STE 2
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-2749
Practice Address - Country:US
Practice Address - Phone:509-844-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60421190909261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service