=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528912292
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VERA WHOLE HEALTH WA, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2026
-----------------------------------------------------
Last Update Date | 02/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1150 POWDER SPRINGS ST
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30064-5287
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-528-2441
-----------------------------------------------------
Fax | 770-528-2657
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 W TOWNE RIDGE PKWY STE 200
-----------------------------------------------------
City | SANDY
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84070-5530
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-395-6973
-----------------------------------------------------
Fax | 206-770-6159
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSING ANALYST AND LEGAL ASST
-----------------------------------------------------
Name | VANYA ELLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 206-395-7870
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------