Active NPI
John Thoburn, PH.D. ABPP
- Family Psychologist
- Bellevue, WA
National Provider Identifier
1023224607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Psychologist
- License
- PY 1823
- Practice address
- 1611 116TH Ave NE
Suite 128
Bellevue, WA 98004-3045 - Phone
- (206) 919-6565
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Psychologist | 103TF0000X | PY 1823 | WA | Primary |
| Marriage & Family Therapist | 106H00000X | LF00001362 | WA |
Addresses
Primary practice location
1611 116TH Ave NE
Suite 128
Bellevue, WA 98004-3045
Mailing address
1611 116TH Ave NE
Suite 128
Bellevue, WA 98004-3045
Phone (206) 919-6565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 1823 | WA | MD | Family Psychologist |
| LF00001362 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1023224607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 116TH AVE NE",
"address_2": "SUITE 128",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043045",
"telephone_number": "206-919-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 116TH AVE NE",
"address_2": "SUITE 128",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043045",
"telephone_number": "206-919-6565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOBURN",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PH.D. ABPP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "WA",
"license": "PY 1823",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "LF00001362",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.