Organization Active NPI

Metta Wellness NW PLLC

  • Clinic/Center
  • Spokane, WA
National Provider Identifier
1457958530
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
METTA WELLNESS NW PLLC
Practice address
904 W Riverside Ave Unit 1107
Spokane, WA 99210-0329
Phone
(509) 255-3527
Fax
(858) 947-2017
NPI assigned
Oct 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Dr. Brendan Gordon Tennefoss, DNP,AGPCNP-BC,ACHPNNPI 1528571130
Title
Nurse Practitioner
Phone
(509) 639-3394

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

904 W Riverside Ave Unit 1107
Spokane, WA 99210-0329

Mailing address

904 W Riverside Ave Unit 1107
Spokane, WA 99210-0329
Phone (509) 255-3527

Other identifiers 4

IdentifierTypeStateIssuer
1528571130OtherNPI
201803923OtherORNURSE PRACTITIONER LICENSE
201709029OtherORNURSE PRACTITIONER LICENSE
1184127169OtherNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.charmhealth.com/ Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

904 W Riverside Ave
Unit 1107
Spokane, WA 99210
Phone (509) 255-3527

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1457958530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W RIVERSIDE AVE UNIT 1107",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992100329",
            "telephone_number": "509-255-3527",
            "fax_number": "858-947-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W RIVERSIDE AVE UNIT 1107",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992100329",
            "telephone_number": "509-255-3527",
            "fax_number": "858-947-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METTA WELLNESS NW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "TENNEFOSS",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "509-639-3394",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP,AGPCNP-BC,ACHPN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1528571130",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "201803923",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "201709029",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1184127169",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.charmhealth.com/",
            "affiliation": "N",
            "endpointDescription": "Message Metta Wellness NW PLLC providers through Charm EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Messaging",
            "address_1": "904 W Riverside Ave Unit 1107",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992100329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.