Provider Demographics
NPI:1215718457
Name:INTEGRA HEALTH AND WELLNESS PLLC
Entity type:Organization
Organization Name:INTEGRA HEALTH AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PUSHAPDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:550-997-0575
Mailing Address - Street 1:17820 E GALAXY CT
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:WA
Mailing Address - Zip Code:99016-7792
Mailing Address - Country:US
Mailing Address - Phone:509-970-5750
Mailing Address - Fax:
Practice Address - Street 1:16201 E INDIANA AVE STE 2260
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2838
Practice Address - Country:US
Practice Address - Phone:509-970-5750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty