Healthcare Provider Details

I. General information

NPI: 1811752181
Provider Name (Legal Business Name): ETHERIOS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 W CENTER ST
OREM UT
84057-4659
US

IV. Provider business mailing address

388 W CENTER ST
OREM UT
84057-4659
US

V. Phone/Fax

Practice location:
  • Phone: 801-960-3131
  • Fax:
Mailing address:
  • Phone: 801-960-3131
  • Fax: 800-785-2607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER GALBRAITH
Title or Position: OWNER
Credential:
Phone: 801-960-3131