Peter Thomas PHD Personal Coporation

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1172 Issued in WA

Legal business name

PETER THOMAS PHD PERSONAL COPORATION

Doing business as

Peter Thomas, PhD

Practice address

19018 Corliss Ave N Ste 300
Shoreline, WA 98133-4146

Phone

(206) 356-8724

Fax

(206) 417-2841

NPI assigned

Aug 16, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter M Thomas, PHDNPI 1376656363

Title

Owner

Phone

(206) 356-8724

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Peter Thomas, PhD Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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

• Peter M Thomas, PHD

  • Clinical Psychologist
  • Seattle, WA
  • NPI 1376656363
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1649383613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19018 CORLISS AVE N STE 300",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334146",
            "telephone_number": "206-356-8724",
            "fax_number": "206-417-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19018 CORLISS AVE N STE 300",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334146",
            "telephone_number": "206-356-8724",
            "fax_number": "206-417-2841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4649 Sunnyside Ave N",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981036900",
            "country_code": "US",
            "telephone_number": "206-634-2162",
            "fax_number": "206-417-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PETER THOMAS PHD PERSONAL COPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-356-8724",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "1172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS COMP PROV#",
            "identifier": "8912335",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES PROV#",
            "identifier": "78567",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "5113341",
            "identifier": "AETNA",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmtho@protonmail.com",
            "affiliation": "N",
            "address_1": "19018 Corliss Ave N Ste 300",
            "city": "Shoreline",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981334146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Peter Thomas, PhD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peter Thomas, PhD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Randi Pedigo
• Jason Penaluna, DC DACNB FABNN
• Erik Pennell
• Melissa People
• Josee F Perez
• Christina Noelle Boscolo Petit, LMT
• Melanie Lundin Petschke, ARNP
• Matthew Pettersen, LAT, ATC
• Jammie Pham
• Theresa Bich Ngoc Pham

• Clinical Psychologist in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.