Theodore Bryan Tennison, CDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP61071467 Issued in WA

Practice address

1415 Center St
Tacoma, WA 98409-8210

Phone

(253) 280-9860

Fax

(253) 280-9870

NPI assigned

Oct 2, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Tacoma, WA
  • NPI 1235287855
  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1962588426
  NPD (past)
• WCHS Inc

  • Methadone Clinic
  • Lakewood, WA
  • NPI 1811039027
  NPD (past)

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1891270153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 CENTER ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984098210",
            "telephone_number": "253-280-9860",
            "fax_number": "253-280-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNISON",
        "first_name": "THEODORE",
        "middle_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-02",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP61071467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Templin, ARNP
• Thomas Paul Templin II, M.D.
• Jennifer Teng
• Ebonie Marie Tennison, CDP
• Nicholas Tennison, DDS
• Alison Teo, MD
• Erica Teo
• Brandy Tep, LMP
• Laurel C. Tepper, LICSW
• Ilsa Marie Teppo, PT, DPT

• Addiction (Substance Use Disorder) Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.