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NPI Code Detail

MEDICARE: TENNILLE SUZANNE CHEDESTER

MEDICARE: TENNILLE SUZANNE CHEDESTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCP60313150WA

General Provider Information

NPI Number : 1073012084
Entity Type Code : Individual
Provider Name (Legal Business Name) : TENNILLE SUZANNE CHEDESTER
Provider Business Mailing Address
First Line : PO BOX 10157
Second Line :
City : SPOKANE
State : WA
Zip : 99209-1157
Country : US
Telephone Number : 509-503-6010
Fax Number :
Provider Business Practice Location Address
First Line : 1302 W GARDNER AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99201-2059
Country : US
Telephone Number : 509-503-6010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2018
Last Update Date : 06/12/2026

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Directions to “ TENNILLE SUZANNE CHEDESTER ” Practice Location

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