Individual
MICHAEL RETALLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1006 SW MELROSE LN, PORT ORCHARD, WA 98367-8306
(360) 633-6782
Mailing address
1006 SW MELROSE LN, PORT ORCHARD, WA 98367-8306
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC61451366
WA
103T00000X
Psychologist
Primary
PY70061210
WA
Other
Enumeration date
06/08/2017
Last updated
02/26/2026
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