Provider Demographics
NPI:1114737418
Name:VERA WHOLE HEALTH WA, PC
Entity type:Organization
Organization Name:VERA WHOLE HEALTH WA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSING ANALYST II
Authorized Official - Prefix:
Authorized Official - First Name:JANELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-395-6973
Mailing Address - Street 1:1201 2ND AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3039
Mailing Address - Country:US
Mailing Address - Phone:206-395-6973
Mailing Address - Fax:206-770-6159
Practice Address - Street 1:3501 OLD GREENWOOD RD STE 10
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5964
Practice Address - Country:US
Practice Address - Phone:206-395-7870
Practice Address - Fax:206-770-6159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care