Jeffrey David Thompson PHD PLLC

Key facts

NPI

1275356347

Entity type

Organization (NPI type 2)

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Legal business name

JEFFREY DAVID THOMPSON PHD PLLC

Practice address

1552 W Goodlander Rd
Selah, WA 98942-8760

Phone

(509) 961-5928

Fax

(509) 737-1494

NPI assigned

Nov 6, 2024

Organization subpart

No

Authorized official

Name

Kristi Smith

Title

Admin

Phone

(509) 308-0276

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey D Thompson, PHD Mental Health Counselor · Selah, WA · NPI 1376873489
  Medicare reassignment NPD WA

Medicare participation

Medicare fee-for-service enrollment

Enrolled in WA

Medicare enrollment records

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 23, 2024.

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732320000000",
    "number": "1275356347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 W GOODLANDER RD",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989428760",
            "telephone_number": "509-961-5928",
            "fax_number": "509-737-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 W GOODLANDER RD",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989428760",
            "telephone_number": "509-961-5928",
            "fax_number": "509-737-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY DAVID THOMPSON PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "509-308-0276"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Selah, WA · Mental Health Clinic/Center (Including Community Mental Health Center) in Washington