Unknown Individual – Internal Medicine Physician, NPI 1447216189

Unknown Individual is a healthcare provider. based in Lake oswego, Oregon. specializing in Internal Medicine Physician. They hold a License No. 9364 (OR). The NPI Number for Unknown Individual is 1447216189

Main info

Organization
Inactive
57 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1447216189
Phone
(503) 635-6256
Address
16463 BOONES FERRY RD # 300
Deactivation Date
16 October 2025

Doctor Profile

Medical School Name
OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5036356256
Graduation Year
1969 (57 years ago)
PAC ID
7012031669
Professional Enrollment ID
I20100902000842
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

  • Boones Ferry Road, Waluga, Lake Grove, Jean, Lake Oswego, Clackamas County, Oregon, 97035, United States

    LAKE OSWEGO, OR 970354259

    Phone: (503) 635-6256

    Fax: (503) 636-9604

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2023-11-11 • Largest payer in this snapshot: ABBVIE INC. ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-11

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$21
View all Open Payments →|Open Payments Risk Radar →

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 97035)

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Reviews

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

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1447216189.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Lake Oswego, Oregon in registry-derived data.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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