Unknown Individual – Optometrist, NPI 1083604656

Unknown Individual is a healthcare provider. based in Portland, Oregon. specializing in Optometrist. They hold a License No. 1935ATI (OR). The NPI Number for Unknown Individual is 1083604656

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083604656
Phone
(503) 286-5060
Address
8523 N LOMBARD ST
Deactivation Date
2 August 2023

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
5032865060
Graduation Year
1986 (40 years ago)
PAC ID
6709770647
Professional Enrollment ID
I20040211000482
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • 8523, North Lombard Street, Saint Johns, Portland, Multnomah County, Oregon, 97203, United States

    PORTLAND, OR 972033103

    Phone: (503) 286-5060

    Fax: (503) 286-3971

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 97203)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1083604656 — is the standard way to identify this listing.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Optometrist. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Portland, Oregon in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

Similar Providers

Moreland Vision Source, 6539, Southeast Milwaukie Avenue, Westmoreland, Sellwood-Moreland, Portland, Metro, Multnomah County, Oregon, 97202, United States
NPI: 1164425948
Northwest Outpatient Medical Center, 10330, Meridian Avenue North, Northgate, Seattle, King County, Washington, 98133, United States
NPI: 1821097056
PO BOX 6989
NPI: 1679572812

Northwest Eye Surgeons

Ophthalmology Physician
PO BOX 6989
NPI: 1487654331

Northwest Eye Surgeons

Ophthalmology Physician
PO BOX 6989
NPI: 1689674517

Northwest Eye Surgeons

Ophthalmology Physician
PO BOX 6989
NPI: 1275533127
South Macadam Avenue, Portland, Metro, Multnomah County, Oregon, 97202, United States
NPI: 1346242997
South Macadam Avenue, Portland, Metro, Multnomah County, Oregon, 97202, United States
NPI: 1639171135

Northwest Eye Surgeons

Ophthalmology Physician
PO BOX 6989
NPI: 1134121593