Unknown Individual – Physical Therapist, NPI 1316443997

Unknown Individual is a healthcare provider. based in Milwaukie, Oregon. specializing in Physical Therapist. They hold a License No. PT19956 (FL). The NPI Number for Unknown Individual is 1316443997

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1316443997
Phone
(503) 659-4988
Address
PO BOX 22075
Deactivation Date
20 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3602569827
Graduation Year
2001 (25 years ago)
PAC ID
5193089183
Group Practice PAC ID
5092861922
Professional Enrollment ID
I20190522001817
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

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

Provider Addresses for Unknown Individual

  • PO BOX 22075

    MILWAUKIE, OR 972692075

    Phone: (503) 659-4988

    Fax: (503) 353-1273

    Type: Mailing

  • 12119 SE STEVENS CT

    HAPPY VALLEY, OR 970862620

    Phone: (503) 353-1278

    Fax: (503) 353-1273

    Type: Location

  • Capital Circle Northeast, Perkins, Tallahassee, Leon County, Florida, 323O1, United States

    TALLAHASSEE, FL 323084476

    Phone: (850) 402-9776

    Fax: (850) 765-6422

    Type: Mailing

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 97269)

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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: 5092861922View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeOR

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1316443997.
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 is Unknown Individual's primary classification?
Physical Therapist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Milwaukie, Oregon in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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