Individual provider Active NPI

Edward J Schau, PH.D.

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1902953664
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00000503 Issued in WA
Practice address
12349 Roosevelt Way NE
Suite 101
Seattle, WA 98125-4852
Phone
(206) 365-3808
Fax
(206) 367-4115
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY00000503 WA Primary

Addresses

Primary practice location

12349 Roosevelt Way NE
Suite 101
Seattle, WA 98125-4852

Mailing address

12349 Roosevelt Way NE
Suite 101
Seattle, WA 98125-4852
Phone (205) 365-3808

Other identifiers 2

IdentifierTypeStateIssuer
5520398OtherWAAETNA
125661OtherWAVALUE OPTIONS

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
PY00000503WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1902953664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12349 ROOSEVELT WAY NE",
            "address_2": "SUITE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254852",
            "telephone_number": "205-365-3808",
            "fax_number": "206-367-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12349 ROOSEVELT WAY NE",
            "address_2": "SUITE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254852",
            "telephone_number": "206-365-3808",
            "fax_number": "206-367-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAU",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00000503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5520398",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "125661",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.