Organization
TIDAL BALANCED WELLNESS CENTER
Active
Other names
Tidal Balanced Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON BARELLO CRAYTON LICSW (OWNER)
(757) 921-7704
Entity
Organization
Contact information
Practice address
325 TACOMA AVE S STE 1, TACOMA, WA 98402-2550
(757) 921-7704
Mailing address
325 TACOMA AVE S STE 1, TACOMA, WA 98402-2550
(757) 921-7704
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
04/10/2024
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