METTA WELLNESS NW PLLC (NPI# 1457958530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457958530 |
| Entity Type | Organization |
| Organization Name | METTA WELLNESS NW PLLC |
| Practice Address |
904 W Riverside Ave Unit 1107 Spokane WA 99210-0329 |
| Practice Telephone | 5092553527 |
| Practice Fax Number | 8589472017 |
| Mailing Telephone | 5092553527 |
| Mailing Fax Number | 8589472017 |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |
| Authorized Official Name | DR. BRENDAN GORDON TENNEFOSS (NURSE PRACTITIONER) |
| Authorized Official Telephone | 5092553527 |
| Authorized Official Credential | DNP,AGPCNP-BC,AC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI | 1184127169 | 01 | |
| NPI | 1528571130 | 01 | |
| OR | NURSE PRACTITIONER LICENSE | 201709029 | 01 |
| OR | NURSE PRACTITIONER LICENSE | 201803923 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | METTA WELLNESS NW PLLC | 904 W Riverside Ave # 1107, Spokane, WA 99210-0329 |
| Street Address |
904 W RIVERSIDE AVE UNIT 1107 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99210-0329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528571130 | Brendan Gordon Tennefoss | Registered Nurse | 904 W Riverside Ave Unit 1107, Spokane, WA 99210-0329 | 2017-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982118394 | Dawn Marie Depriest | Nurse Practitioner | 600 N. Riverfront Blvd, Esfcom, Spokane, WA 99210 | 2017-11-21 |
| 1760641021 | Spokane Hyperbaric and Wound Care Consultants Ps | General Practice | West 800 Fifth Ave, Deaconess Medical Center, Spokane, WA 99210 | 2008-06-03 |
| 1144552704 | Northwest Pacific Emergency Physicians LLP | Emergency Medicine | 800 West Fifth Avenue, Spokane, WA 99210-0248 | 2010-02-08 |
| 1861563579 | Susan Marie Edgerly | Dietitian, Registered | 800 W 5th Ave, Spokane, WA 99210-0248 | 2006-11-13 |
| 1649482654 | Judith L Engel | Dietitian, Registered | Shriners Hospital for Children Spokane, 911 W 5th Avenue, Spokane, WA 99210-2472 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811748 | Gymnastics, Rehabilitation, and Independence Programs LLC | Occupational Therapist | 1304 E 5th Ave, Spokane, WA 99202-2308 | 2020-11-08 |
| 1437750817 | Nw Family Psychology Rock Pointe | Counselor | 1212 N Washington St Ste 105, Spokane, WA 99201-2441 | 2020-11-03 |
| 1588264287 | Mary Elleinne Felix Valentin | Registered Nurse | 8452 N Farmdale Ct, Spokane, WA 99208-6884 | 2020-10-30 |
| 1013517952 | Maria Escobedo | Counselor | 1321 N. Ash, Spokane, WA 99201 | 2020-10-29 |
| 1992305981 | Stephanie Camper | Physical Therapist | 5412 S Madelia St, Spokane, WA 99223-8147 | 2020-10-28 |
| 1972103026 | River City Tms, Pllc | Psychologist | 400 S Jefferson St Ste 118, Spokane, WA 99204-3142 | 2020-10-28 |
| 1043819550 | Ginger Lee Grey | Counselor | 1325 W 1st Ave Ste 314, Spokane, WA 99201-4135 | 2020-10-26 |
| 1457950909 | Daniela Brown I | Occupational Therapist | 5618 N Fleming St, Spokane, WA 99205-7448 | 2020-10-25 |
| 1306445150 | Healthy Bodies Nutrition | Dietitian, Registered | 12808 E Apache Pass Rd, Spokane, WA 99206-9309 | 2020-10-22 |
| 1871192567 | Chelsey Michelle Pangborn | Recreation Therapist | 4815 N Assembly St Bldg 31, Spokane, WA 99205-6185 | 2020-10-22 |
| Find all providers in SPOKANE | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801350350 | Ideal Option, Pllc | Clinic/Center | 901 N Monroe St Ste 322, Spokane, WA 99201-2148 | 2019-01-29 |
| 1679087043 | Amw Wellness LLC | Clinic/Center | 906 W 2nd Ave Fl 6, Spokane, WA 99201-4538 | 2017-11-21 |
| 1629319850 | Institute Medical Services, LLC | Clinic/Center | 10 N Post St, Spokane, WA 99201-0712 | 2013-03-13 |
| 1639357940 | Edward L Charbonneau, Dds | Clinic/Center | 1520 W Garland Ave, Spokane, WA 99205-2613 | 2008-02-08 |
| 1730378308 | D. Todd Wylie, O.d., Inc. | Clinic/Center | 104 S Freya Street, Suite 220, White Flag Bldg, Spokane, WA 99202-4867 | 2007-10-19 |
| 1770074965 | Inland Northwest Health Services | Clinic/Center | 501 N Riverpoint Blvd Ste 245, Spokane, WA 99202-1649 | 2018-05-23 |
| 1306391446 | Providence Health & Services Washington | Clinic/Center | 2923 E 29th Ave, Spokane, WA 99223-4811 | 2016-08-18 |
| 1376097279 | Sport & Spine LLC | Clinic/Center | 3209 E 57th Ave, Ste F, Spokane, WA 99223-7040 | 2016-08-09 |
| 1396143319 | Inkare, LLC | Clinic/Center | 611 E 2nd Ave, Suite B, Spokane, WA 99202-6010 | 2014-12-07 |
| 1548674872 | Douglas W. Lyman, Od, Pllc | Clinic/Center | 7619 N Division St, Spokane, WA 99208-5613 | 2014-06-14 |
| Find all providers in SPOKANE | ||||
Please comment or provide details below to improve the information on METTA WELLNESS NW PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.