Healthcare Provider Details

I. General information

NPI: 1396332748
Provider Name (Legal Business Name): ENDEAVOR MENTAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 03/06/2022
Certification Date: 03/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32650 STATE ROUTE 20 STE C209
OAK HARBOR WA
98277-2687
US

IV. Provider business mailing address

316 SE PIONEER WAY STE 106
OAK HARBOR WA
98277-5716
US

V. Phone/Fax

Practice location:
  • Phone: 360-914-5744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HOLLYE HAHN
Title or Position: OWNER
Credential: ARNP, PMHNP-BC
Phone: 360-914-5744