Organization
HEALING WINGS INTERNATIONAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI LABRECQUE (ACCTS. MGR)
(702) 453-3799
Entity
Organization
Contact information
Practice address
1221 HIGHLAND AVE, CLARKSTON, WA 99403-2829
(509) 758-5511
Mailing address
PO BOX 90279, PHOENIX, AZ 85066-0279
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60394820
WA
208M00000X
Hospitalist Physician
Primary
MD603948250
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD60394820
MD60394820
WA
Enumeration date
07/29/2013
Last updated
07/29/2013
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