Healthcare Provider Details

I. General information

NPI: 1518686252
Provider Name (Legal Business Name): ELAMAX MENTAL HEALTH SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BROADWAY STE 100
TACOMA WA
98402-3900
US

IV. Provider business mailing address

401 BROADWAY STE 100
TACOMA WA
98402-3900
US

V. Phone/Fax

Practice location:
  • Phone: 253-285-1134
  • Fax: 253-237-9372
Mailing address:
  • Phone: 253-285-1134
  • Fax: 253-237-9372

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: DEANETTE JAMES
Title or Position: OWNER
Credential: MSN, APRN, PMHNP-BC
Phone: 253-285-1134