Healthcare Provider Details

I. General information

NPI: 1568308724
Provider Name (Legal Business Name): ELEVATE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 CEDAR AVE
SNOHOMISH WA
98290-2817
US

IV. Provider business mailing address

304 CEDAR AVE
SNOHOMISH WA
98290-2817
US

V. Phone/Fax

Practice location:
  • Phone: 360-908-5003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE BLANSHAN
Title or Position: FNP
Credential: ARNP
Phone: 360-908-5003