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General NPI Number Information
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NPI Number | 1700379682
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Entity Type | Organization
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Legal Business Name | VERA WHOLE HEALTH WA PC
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 219 PHIL MEADOR AVE
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City | POCATELLO
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State | ID
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Zip | 83202
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Country | US
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Telephone | 208-810-4715
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Fax | 208-473-2964
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Provider Business Mailing Address
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Address Line | 100 W TOWNE RIDGE PKWY STE 200
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City | SANDY
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State | UT
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Zip | 84070-5530
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Country | US
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Telephone | 206-398-7870
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Fax |
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Authorized Official
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Title or Position | LICENSING ANALYST & LEGAL ASST
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Name | VANYA ELLER
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Credential |
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Telephone | 206-395-7870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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