Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Edward L Deatherage, PHD

Individual provider Clinical Psychologist · NPI 1720141575

Dr. Edward L Deatherage, PHD is a Clinical Psychologist in Spokane, Washington. Qualified in 1977, 49 years ago. Practices with Mental Health Specialty Group PA, a 679-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
49
Licensed in
WA
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

5814 S Thistle Ln
Spokane, WA 99223-1702
Phone: (208) 651-0179
Fax: (208) 651-0179
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PY00000714 (WA)

Record details

NPI number1720141575
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedDecember 19, 2006
Last updated in NPPESJune 21, 2016
Mailing address5814 S Thistle Ln, Spokane, WA 99223-1702

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1977 (49 years in practice)
Group practice Mental Health Specialty Group Pa — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Spokane