Unknown Individual – Psychiatric/Mental Health Nurse Practitioner, NPI 1346415056

Unknown Individual is a healthcare provider. based in Eugene, Oregon. specializing in Psychiatric/Mental Health Nurse Practitioner. They hold a License No. 200450009NP-PP (OR). The NPI Number for Unknown Individual is 1346415056

Main info

Organization
Inactive
22 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1346415056
Phone
(541) 687-6983
Address
1255 PEARL ST
Deactivation Date
26 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5416876983
Graduation Year
2004 (22 years ago)
PAC ID
2860688280
Group Practice PAC ID
1658674197
Professional Enrollment ID
I20101124000998
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

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Provider Addresses for Unknown Individual

  • 1255, Pearl Street, Eugene, Lane County, Oregon, 97401, United States

    SUITE 102

    EUGENE, OR 974013570

    Phone: (541) 687-6983

    Fax: (541) 687-2063

    Mailing address matches the actual address.

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 97401)

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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: 1658674197View full group profile
NameSpecialtyState
Mental Health CounselorOR
Marriage And Family TherapistOR
Marriage And Family TherapistOR
Nurse PractitionerOR
Marriage And Family TherapistOR
Mental Health CounselorOR
Mental Health CounselorOR
Clinical Social WorkerOR
Mental Health CounselorOR
-OR

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1346415056 — 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 healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Eugene, Oregon in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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