Organization
METTA WELLNESS NW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDAN GORDON TENNEFOSS DNP,AGPCNP-BC,ACHPN (NURSE PRACTITIONER)
(509) 639-3394
Entity
Organization
Contact information
Practice address
904 W RIVERSIDE AVE UNIT 1107, SPOKANE, WA 99210-0329
(509) 255-3527
(858) 947-2017
Mailing address
904 W RIVERSIDE AVE UNIT 1107, SPOKANE, WA 99210-0329
(509) 255-3527
(858) 947-2017
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184127169
NPI
—
01
—
1528571130
NPI
—
01
—
201709029
NURSE PRACTITIONER LICENSE
OR
01
—
201803923
NURSE PRACTITIONER LICENSE
OR
Enumeration date
10/02/2020
Last updated
01/27/2025
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