Healthcare Provider Details

I. General information

NPI: 1407939911
Provider Name (Legal Business Name): JUNE MARIE HENSLEY M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19319 7TH AVE NE STE 102
POULSBO WA
98370-7442
US

IV. Provider business mailing address

19319 7TH AVE NE STE 102
POULSBO WA
98370-7442
US

V. Phone/Fax

Practice location:
  • Phone: 360-697-3061
  • Fax: 360-697-2116
Mailing address:
  • Phone: 360-697-3061
  • Fax: 360-697-2116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD00003792
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberLD00003792
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: