Individual provider Active NPI

William L Thorbecke, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Vancouver, WA
National Provider Identifier
1891739413
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
1538 Issued in WA
Practice address
108 SE 124RTH Avenue
Vancouver, WA 98684
Phone
(360) 690-8385
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 1538 WA Primary
Clinical Child & Adolescent Psychologist 103TC2200X 1007 OR

Addresses

Primary practice location

108 SE 124RTH Avenue
Vancouver, WA 98684

Mailing address

2703 NW 32ND Ave
Camas, WA 98607-7355
Phone (360) 833-0834

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
1007ORMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1891739413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 NW 32ND AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077355",
            "telephone_number": "360-833-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SE 124RTH AVENUE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98684",
            "telephone_number": "360-690-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORBECKE",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "1538",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OR",
            "license": "1007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.