Healthcare Provider Details

I. General information

NPI: 1104654003
Provider Name (Legal Business Name): VERA WHOLE HEALTH WA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7135 W SAHARA AVE STE 100
LAS VEGAS NV
89117-2828
US

IV. Provider business mailing address

1201 2ND AVE STE 1400
SEATTLE WA
98101-3039
US

V. Phone/Fax

Practice location:
  • Phone: 702-222-9355
  • Fax: 725-201-6788
Mailing address:
  • Phone: 206-396-7863
  • Fax: 206-770-6159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JANELL HANSEN
Title or Position: LICENSING ANALYST
Credential:
Phone: 206-395-6973