Provider Demographics
NPI:1700379682
Name:VERA WHOLE HEALTH WA PC
Entity Type:Organization
Organization Name:VERA WHOLE HEALTH WA PC
Other - Org Name:AMY'S FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSING ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSCHFELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-395-7870
Mailing Address - Street 1:1201 2ND AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3020
Mailing Address - Country:US
Mailing Address - Phone:206-398-7870
Mailing Address - Fax:
Practice Address - Street 1:219 PHIL MEADOR AVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83202
Practice Address - Country:US
Practice Address - Phone:208-810-4715
Practice Address - Fax:208-473-2964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care