Healthcare Provider Details

I. General information

NPI: 1073447512
Provider Name (Legal Business Name): JESSICA LYNN ELKINS LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20327 86TH AVENUE CT E
SPANAWAY WA
98387-5007
US

IV. Provider business mailing address

20327 86TH AVENUE CT E
SPANAWAY WA
98387-5007
US

V. Phone/Fax

Practice location:
  • Phone: 760-505-9110
  • Fax:
Mailing address:
  • Phone: 760-505-9110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: