MEDICARE: VERA WHOLE HEALTH WA PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1427732544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERA WHOLE HEALTH WA PC

Provider Business Mailing Address
First Line	:	100 W TOWNE RIDGE PKWY STE 200
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84070-5530
Country	:	US
Telephone Number	:	206-395-7870
Fax Number	:	206-770-6159

Provider Business Practice Location Address
First Line	:	1250 SCENIC HWY S STE 1260
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-7822
Country	:	US
Telephone Number	:	678-831-4800
Fax Number	:	678-868-1527

Authorized Official
Title or Position	:	LICENSING ANALYST
Name	:	JANELL HANSEN
Credential	:
Telephone Number	:	206-395-6973

Provider Enumeration Date	:	06/09/2023
Last Update Date	:	01/12/2026

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