Organization
ELEVATE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGGORY MORTENSEN (OWNER/PHYSICAL THERAPIST)
(360) 605-0416
Entity
Organization
Contact information
Practice address
7701 NE HIGHWAY 99 STE 109, VANCOUVER, WA 98665-8871
(360) 605-0416
(360) 605-0417
Mailing address
7701 NE HIGHWAY 99 STE 109, VANCOUVER, WA 98665-8871
(360) 605-0416
(360) 605-0417
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61158
OR STATE LICENSE
OR
01
—
PT-60735053
WA STATE LICENSE
WA
Enumeration date
08/23/2019
Last updated
03/29/2021
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