Provider Demographics
NPI:1316661010
Name:EVOLVE AND ELEVATE, LLC
Entity type:Organization
Organization Name:EVOLVE AND ELEVATE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:TORREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:THILLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:971-710-8287
Mailing Address - Street 1:2093 NW YUCCA WAY
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-8549
Mailing Address - Country:US
Mailing Address - Phone:971-710-8287
Mailing Address - Fax:503-821-7821
Practice Address - Street 1:2000 NE 42ND AVE # 1085
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1399
Practice Address - Country:US
Practice Address - Phone:971-710-8287
Practice Address - Fax:503-821-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-27
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health