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General NPI Number Information
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NPI Number | 1518686252
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Entity Type | Organization
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Legal Business Name | ELAMAX MENTAL HEALTH SERVICES PLLC
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 401 BROADWAY STE 100
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City | TACOMA
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State | WA
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Zip | 98402-3900
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Country | US
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Telephone | 253-285-1134
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Fax | 253-237-9372
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Provider Business Mailing Address
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Address Line | 401 BROADWAY STE 100
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City | TACOMA
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State | WA
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Zip | 98402-3900
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Country | US
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Telephone | 253-285-1134
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Fax | 253-237-9372
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Authorized Official
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Title or Position | OWNER
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Name | DEANETTE JAMES
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Credential | MSN, APRN, PMHNP-BC
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Telephone | 253-285-1134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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