Active NPI
Metta Wellness NW PLLC
- Clinic/Center
- Spokane, WA
National Provider Identifier
1457958530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- 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
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,ACHPN
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528571130 | Other | NPI | |
| 201803923 | Other | OR | NURSE PRACTITIONER LICENSE |
| 201709029 | Other | OR | NURSE PRACTITIONER LICENSE |
| 1184127169 | Other | NPI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://www.charmhealth.com/ | Health Information Exchange (HIE) |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Nurse Practitioner
- Spokane, WA
- NPI 1528571130
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.