Individual provider Active NPI

Thomas Jess Smurthwaite, PHD

  • Counseling Psychologist
  • Clackamas, OR
National Provider Identifier
1750495875
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1023 Issued in OR
Practice address
10163 SE Sunnyside Rd Ste 490
Clackamas, OR 97015-5720
Phone
(503) 513-4400
NPI assigned
Aug 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Counseling Psychologist 103TC1900X 1023 OR Primary

Addresses

Primary practice location

10163 SE Sunnyside Rd Ste 490
Clackamas, OR 97015-5720

Mailing address

10163 SE Sunnyside Rd Ste 490
Clackamas, OR 97015-5720
Phone (503) 513-4400

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1023ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750495875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10163 SE SUNNYSIDE RD STE 490",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155720",
            "telephone_number": "503-513-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10163 SE SUNNYSIDE RD STE 490",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155720",
            "telephone_number": "503-513-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMURTHWAITE",
        "first_name": "THOMAS",
        "middle_name": "JESS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OR",
            "license": "1023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

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.