Healthcare Provider Details

I. General information

NPI: 1578512133
Provider Name (Legal Business Name): TERREL L. TEMPLEMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 SE 1ST ST
PENDLETON OR
97801-2203
US

IV. Provider business mailing address

135 SE 1ST ST
PENDLETON OR
97801-2203
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-2222
  • Fax: 541-276-8405
Mailing address:
  • Phone: 541-278-2222
  • Fax: 541-276-8405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0449
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: