MEDICARE: THOMAS DESHLER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	0817	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	117803	OTHER	OR	MHN PROV.

General Provider Information

NPI Number	:	1134221690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS DESHLER PH.D.

Provider Business Mailing Address
First Line	:	610 JEFFERSON ST
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-2329
Country	:	US
Telephone Number	:	503-657-7235
Fax Number	:	503-657-7676

Provider Business Practice Location Address
First Line	:	610 JEFFERSON ST
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-2329
Country	:	US
Telephone Number	:	503-657-7235
Fax Number	:	503-657-7676

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2006
Last Update Date	:	07/08/2007

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Directions to “ THOMAS DESHLER PH.D.” Practice Location

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