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1891270153
THEODORE BRYAN TENNISON
TACOMA, WA
NPI
1891270153
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CP61071467)
Enumeration Date
2018-10-02
Last Update Date
2022-10-19
Business Address
Mr. THEODORE BRYAN TENNISON CDPT
1415 CENTER ST
TACOMA, WA 98409-8210
Phone number: 253-280-9860
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Mailing Address
Mr. THEODORE BRYAN TENNISON CDPT
PO BOX 34703
SEATTLE, WA 98124-1703
Phone number:
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