Active NPI
Peter J Theobald
- Counselor
- Spokane, WA
National Provider Identifier
1659569481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- RC00058671
- Practice address
- 3919 N Maple St
Spokane, WA 99205-1349 - Phone
- (509) 444-8888
- Fax
- (509) 444-7806
- NPI assigned
- Oct 5, 2007
- Last updated
- Oct 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | RC00058671 | WA | Primary |
Addresses
Primary practice location
3919 N Maple St
Spokane, WA 99205-1349
Mailing address
3919 N Maple St
Spokane, WA 99205-1349
Phone (509) 444-8888
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00058671 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191542400000",
"number": "1659569481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3919 N MAPLE ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992051349",
"telephone_number": "509-444-8888",
"fax_number": "509-444-7806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3919 N MAPLE ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992051349",
"telephone_number": "509-444-8888",
"fax_number": "509-444-7806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEOBALD",
"first_name": "PETER",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-05",
"last_updated": "2007-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "RC00058671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
- The Salvation Army Spokane Corp
- The Shades of Motherhood Network
- The Wisdom Well LLC (The Wisdom Well)
- Annetta Elizabeth Theademan, CO60546132
- Catherine Theobald
- Angelica Rose Theophile, BEHAVIORAL SUPPORT
- Therapeutic Associates Inc (TAI - Advantage PT Downtown)
- Therapeutic Associates Inc (TAI - Spokane Physical Therapy)
- Therapeutic Associates Inc (TAI - Advantage PT South Hill)
- Therapeutic Associates Inc (Therapeutic Associates, Inc. Northside Physical Therapy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.