Organization
ELEVATE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER DENISE GLENN LPC INTERN, NCC, CRC (OWNER)
(541) 337-6381
Entity
Organization
Contact information
Practice address
6700 SW 105TH AVE STE 203, BEAVERTON, OR 97008-8824
(503) 435-7663
Mailing address
6700 SW 105TH AVE STE 203, BEAVERTON, OR 97008-8824
(503) 435-7663
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
R4844
OR
Other
Enumeration date
09/28/2017
Last updated
07/21/2022
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