Andrew Jordan Thayer, PH.D., LP

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY61194044 Issued in WA

Practice address

509 Olive Way Ste 204
Seattle, WA 98101-1726

Phone

(307) 751-5025

NPI assigned

Jul 30, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1902415342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY STE 204",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011726",
            "telephone_number": "307-751-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY STE 204",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011726",
            "telephone_number": "307-751-5025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 S 44th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681313727",
            "country_code": "US",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAYER",
        "first_name": "ANDREW",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-30",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "12174",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61194044",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "PY61194044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Nystrom Tharp, M.ED.
• Julie A Thatcher, LMHCA
• Ricky Thatsanavongsa
• Gayhtoo Thaw
• Jeffrey Thaxton
• Meta Britton Thayer, P.T.
• Thayne Doyle
• THC - Seattle, LLC
• THC Seattle Inc
• THC-Seattle LLC

• Clinical Child & Adolescent Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Child & Adolescent Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.