Provider Demographics
NPI:1972366334
Name:ELEVATION PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:ELEVATION PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:KATZENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:253-486-7735
Mailing Address - Street 1:1503 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-5718
Mailing Address - Country:US
Mailing Address - Phone:253-486-7735
Mailing Address - Fax:
Practice Address - Street 1:1503 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-5718
Practice Address - Country:US
Practice Address - Phone:253-486-7735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health