Provider Demographics
NPI:1437280872
Name:ELF, JENNIFER L (MS)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:ELF
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10322 NE 190TH ST
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-2916
Mailing Address - Country:US
Mailing Address - Phone:425-770-9642
Mailing Address - Fax:
Practice Address - Street 1:10322 NE 190TH ST
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-2916
Practice Address - Country:US
Practice Address - Phone:425-770-9642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005164101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health