Most Relevant Information
Provider Data
| NPI Number: | 1003443482 |
| Provider Name: | LAURA LYNN TENNEY SUDPT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | CO61489652 |
Most Important Dates
| Enumeration Date: | 03/25/2020 |
| Last Updated: | 11/20/2023 |
Provider Practice Location
1601 E FOURTH PLAIN BLVD BLDG 17
VANCOUVER
WA
986613717
Practice Location Phone/Fax
| Phone: | 3603978246 |
| Fax: | 3603978250 |
Provider Mailing Location
13852 NW 10TH CT APT B
VANCOUVER
WA
986851905
Provider Mailing Phone/Fax
| Phone: | 3609019827 |
| Fax: |