Individual provider Active NPI

Terrence Edward Schomburg, PH.D.

  • Psychologist
  • Tacoma, WA
National Provider Identifier
1699982009
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3740 Issued in WA
Practice address
2421 S Union Ave
No. 279
Tacoma, WA 98405-1360
Phone
(253) 686-8210
Fax
(253) 503-6655
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3740 WA Primary

Addresses

Primary practice location

2421 S Union Ave
No. 279
Tacoma, WA 98405-1360

Mailing address

2421 S Union Ave
No. 279
Tacoma, WA 98405-1360
Phone (253) 686-8210

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3740WAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699982009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 S UNION AVE",
            "address_2": "NO. 279",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051360",
            "telephone_number": "253-686-8210",
            "fax_number": "253-503-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 S UNION AVE",
            "address_2": "NO. 279",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051360",
            "telephone_number": "253-686-8210",
            "fax_number": "253-503-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOMBURG",
        "first_name": "TERRENCE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "3740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.