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General NPI Number Information
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NPI Number | 1972366334
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Entity Type | Organization
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Legal Business Name | ELEVATION PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 01/30/2024
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Last Update Date | 05/04/2025
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Provider Practice Location Address
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Address Line | 2607 BRIDGEPORT WAY W STE 2D
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4725
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Country | US
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Telephone | 253-446-2319
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Fax | 253-375-1653
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Provider Business Mailing Address
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Address Line | 2607 BRIDGEPORT WAY W STE 2D
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4725
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Country | US
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Telephone | 253-486-7735
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Fax | 253-375-1653
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Authorized Official
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Title or Position | MEMBER
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Name | RAY JASON KATZENBACH
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Credential | PH.D.
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Telephone | 253-486-7735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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