Unknown Individual – Nutrition Chiropractor, NPI 1205993300

Unknown Individual is a healthcare provider. based in Sisters, Oregon. specializing in Nutrition Chiropractor. They hold a License No. 1533 (OR). The NPI Number for Unknown Individual is 1205993300

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1205993300
Phone
(541) 549-0624
Address
PO BOX 1896
Deactivation Date
18 October 2021

Doctor Profile

Medical School Name
WESTERN STATES COLLEGE OF CHIROPRACTIC
Secondary Phone
5415490624
Graduation Year
1980 (46 years ago)
PAC ID
0143350397
Professional Enrollment ID
I20100614000876
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Sisters Post Office, 694, North Larch Street, Sisters, Deschutes County, Oregon, 97759, United States

    SISTERS, OR 977591896

    Phone: (541) 549-0624

    Fax: (541) 549-3565

    Type: Mailing

  • North Larch Street, Sisters, Deschutes County, Oregon, 97759, United States

    SISTERS, OR 97759

    Phone: (541) 549-0624

    Fax: (541) 549-3565

    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.

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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 97759)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1205993300 — is the standard way to identify this listing.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Nutrition Chiropractor in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Sisters, Oregon may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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