# POULSBO THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Poulsbo Therapy and Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073304010
- **Authorized official:** MRS. SHANNON JUNE TALLON (OWNER)
- **Authorized official phone:** (360) 621-4837

## Contact information

- **Practice address:** 19980 10TH AVE NE STE 204G, POULSBO, WA 98370-6431
- **Practice address phone:** (360) 621-4837
- **Practice address fax:** (866) 892-0602
- **Mailing address:** 19980 10TH AVE NE STE 204G, POULSBO, WA 98370-6431
- **Mailing address phone:** (360) 621-4837
- **Mailing address fax:** (866) 892-0602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2025
- **Last updated:** 05/16/2025