Demetria F Tennefoss, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP61074664 Issued in WA

Practice address

123 E Indiana Ave
Spokane, WA 99207-2313

Phone

(866) 904-7721

Fax

(509) 248-3644

NPI assigned

Mar 15, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Planned Parenthood of Greater Washington & North Idaho

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1346226750

  Multi-Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1184127169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "360-729-1459",
            "fax_number": "360-729-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E INDIANA AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992072313",
            "telephone_number": "866-904-7721",
            "fax_number": "509-248-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Hilyard St Ste 510",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "97401",
            "country_code": "US",
            "telephone_number": "541-687-6282",
            "fax_number": "541-687-6154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TENNEFOSS",
        "first_name": "DEMETRIA",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "2017076T8RN",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201803923NP-PP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61074664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Temple, LMHCA
• Joel Templin
• Shirley S Tengbom, RN
• Brian Tennant, MSN, CNP
• Brendan Gordon Tennefoss, DNP, AGPCNP, ACHPN
• Frances Lynn Tennican, P.T.
• Patrick O'Malley Tennican, M.D.
• Ryan Neil Kennedy Tenold, D.O.
• Rayanna Tensley
• Maro Ter-Ogannisyan, LSWAIC

• Nurse Practitioner in Spokane, WA
• Providers in Spokane, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.