Provider Demographics
NPI:1932435989
Name:TENNANT, BETHANY SARAH (ND)
Entity type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:SARAH
Last Name:TENNANT
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13144 SW BRIANNE WAY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-0678
Mailing Address - Country:US
Mailing Address - Phone:607-793-1298
Mailing Address - Fax:
Practice Address - Street 1:14900 SW BARROWS RD STE 201
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-7501
Practice Address - Country:US
Practice Address - Phone:503-246-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022349225700000X
OR4068175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist