Individual
EBONIE MARIE TENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
3101 S TACOMA WAY, TACOMA, WA 98409-4717
(253) 396-5800
Mailing address
6700 MARTIN WAY E STE 117, OLYMPIA, WA 98516-5586
(360) 413-6910
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61011133
WA
Other
Enumeration date
10/01/2018
Last updated
10/18/2021
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