Shannon Jacobson

Individual provider Active NPI Massage Therapist · Vergennes, VT

NPI 1386564557 · NPPES record last updated Jul 17, 2026

Key facts

NPI
1386564557
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
Practice address
92 Main St
Vergennes, VT 05491-1155
Phone
(206) 226-6381
NPI assigned
Jul 17, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225700000X VT Yes

Addresses

Primary practice location

92 Main St
Vergennes, VT 05491-1155

Mailing address

75 W Main St
Vergennes, VT 05491-1064
Phone (206) 226-6381

Other names

  • Shannon Coultas Former name

Other providers in Vergennes, VT

All providers in Vergennes, VT · Massage Therapist in Vermont

Sources for this page

Verify at the official NPI Registry.