Provider Demographics
NPI:1720257215
Name:TERHAAR, EDWARD JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:TERHAAR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8393
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-0393
Mailing Address - Country:US
Mailing Address - Phone:509-838-2111
Mailing Address - Fax:509-838-2111
Practice Address - Street 1:9203 E TRENT AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4216
Practice Address - Country:US
Practice Address - Phone:509-838-2111
Practice Address - Fax:509-838-2111
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA20000262101YA0400X
WA020703-LH00005453101YM0800X
WA020705-FF00001053106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist