Provider Demographics
NPI:1891005179
Name:WHOLEY HEALING
Entity Type:Organization
Organization Name:WHOLEY HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FALER
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:509-474-0597
Mailing Address - Street 1:8817 E MISSION AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-5034
Mailing Address - Country:US
Mailing Address - Phone:509-474-0597
Mailing Address - Fax:509-474-9857
Practice Address - Street 1:8817 E MISSION AVE STE 106
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-5034
Practice Address - Country:US
Practice Address - Phone:509-474-0597
Practice Address - Fax:509-474-9857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001500207Q00000X
WAAP30007639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1124140116OtherNPI
WA9652546Medicaid
WA1245438761OtherNPI
WA1245438761OtherNPI