Unknown Individual – Clinical Social Worker, NPI 1033238464

Unknown Individual is a healthcare provider. based in Redmond, Oregon. specializing in CLINICAL SOCIAL WORKER. They hold a License No. L11728 (OR). The NPI Number for Unknown Individual is 1033238464

Main info

Organization
Inactive
8 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1033238464
Phone
(541) 904-5216
Address
7515 FALCON CREST DR # 200
Deactivation Date
2 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5419045216
Graduation Year
2018 (8 years ago)
PAC ID
8820524630
Group Practice PAC ID
4688907827
Professional Enrollment ID
I20241203004197
Address ID
OR977565014RE7515XDRXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

1,405 CLINICAL SOCIAL WORKER in OR

Provider Addresses for Unknown Individual

  • 7515 FALCON CREST DR # 200

    REDMOND, OR 977565014

    Phone: (541) 904-5216

    Fax: (541) 527-4347

    Type: Mailing

  • 2073 OLYMPIC ST

    SPRINGFIELD, OR 974773413

    Phone: (541) 682-3550

    Fax: (541) 682-3551

    Type: Mailing

  • 2411 MARTIN LUTHER KING JR BLVD

    EUGENE, OR 97401

    Phone: (541) 682-3608

    Fax: (541) 682-3276

    Type: Location

  • 2222 Coburg Road

    Eugene, OR 97401

    Phone: (458) 210-2984

    Fax: (458) 210-2985

    Type: Location

  • 2411 Martin Luther King Jr Blvd

    Eugene, OR 97401

    Phone: (541) 682-3608

    Fax: (541) 682-3276

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97756)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688907827View full group profile
NameSpecialtyState
Clinical Social WorkerOR
Clinical Social WorkerOR
Mental Health CounselorOR
Clinical Social WorkerCO
Mental Health CounselorOR
Mental Health CounselorOR
Mental Health CounselorOR
Mental Health CounselorOR
Clinical Social WorkerOR
Clinical Social WorkerWY

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1033238464; it appears in the national provider directory.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Clinical Social Worker for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Redmond, Oregon for Unknown Individual based on available NPPES addresses.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1033238464. Always confirm identity and privileges with the practice and licensing boards.

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