Individual
SIMON S TEDROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDP
Contact information
Practice address
8514 W GAGE BLVD STE G, KENNEWICK, WA 99336-8108
(877) 522-1275
Mailing address
4211 SINAI CT, PASCO, WA 99301-8243
(877) 522-1275
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60215848
WA
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
04/11/2016
Last updated
11/21/2022
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