Unknown Individual – Psychiatric/Mental Health Nurse Practitioner, NPI 1689990236

Psychiatric/Mental Health Nurse Practitioner

Unknown Individual is a healthcare provider. based in North bend, Oregon. specializing in Psychiatric/Mental Health Nurse Practitioner. They hold a License No. 200941082RN (OR). The NPI Number for Unknown Individual is 1689990236

Main info

Organization

Inactive

11 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1689990236

Phone

(541) 751-2500

Address

1975 MCPHERSON ST

Deactivation Date

28 December 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

5412666700

Graduation Year

2015 (11 years ago)

PAC ID

0042529141

Group Practice PAC ID

1759353071

Professional Enrollment ID

I20151012000518

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience23

Completeness75

Years active:0State licenses:2Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

McPherson Street, South Bend, Saint Joseph County, Indiana, 46601, United States
SUITE 2
NORTH BEND, OR 974593482
Phone: (541) 751-2500
Fax: (541) 751-2661
Type: Mailing
281, Laclair Street, Coos Bay, Coos County, Oregon, 97420, United States
COOS BAY, OR 974202988
Phone: (541) 266-6700
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 97459)

Loading plans...

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: 1759353071View full group profile

Name	Specialty	State
JACOB RYAN STRADLING (PMHNP)	Nurse Practitioner	OR
JOHNNI JO CANSLER (APRN)	Nurse Practitioner	KY
AHOU BERTHE ARTERBURN (PMHNP)	Nurse Practitioner	KS
ALEXANDRA RAE MICKLEWRIGHT (DNP, PMHNP-BC)	Nurse Practitioner	MT
DR. JEANINE SHANNON-ALLISON COLLIER (M.D.)	-	OR
ALOYCHA LI DE LA ROCHE (APRN,BC)	Nurse Practitioner	NV

Reviews

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

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How is Unknown Individual identified in CMS data?

CMS-hosted NPPES data lists Unknown Individual with NPI 1689990236.

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 Psychiatric/Mental Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.

What area does Unknown Individual serve?

Unknown Individual's listing highlights North Bend, Oregon; more addresses can appear in NPPES.

What does 'Individual Provider' mean on this profile?

Entity type tells you whether the number belongs to a person or an organization.