Unknown Individual – Clinical Social Worker, NPI 1356499842

Unknown Individual is a healthcare provider. based in Manzanita, Oregon. specializing in Clinical Social Worker. They hold a License No. 2057 (OR). The NPI Number for Unknown Individual is 1356499842

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356499842
Phone
(150) 336-8686
Address
PO BOX 178
Deactivation Date
12 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5033683799
Graduation Year
1990 (36 years ago)
PAC ID
3779809686
Professional Enrollment ID
I20150311000885
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

  • PO BOX 178

    MANZANITA, OR 971300178

    Phone: (150) 336-8686

    Fax: (150) 336-8497

    Type: Mailing

  • 855, West 3rd Street, Shamrock, Wheeler County, Texas, 79079, United States

    WHEELER, OR 971479999

    Phone: (150) 336-8686

    Fax: (150) 336-8497

    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 97130)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1356499842 as the unique 10-digit identifier.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where in Oregon is Unknown Individual registered?
Use Manzanita, Oregon as the headline location for Unknown Individual here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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