Unknown Individual – Optometrist, NPI 1003918988

Unknown Individual is a healthcare provider. based in Montesano, Washington. specializing in Optometrist. They hold a License No. OD00000891 (WA). The NPI Number for Unknown Individual is 1003918988

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1003918988
Phone
(360) 249-2243
Address
304 NORTH TALBOT STREET
Deactivation Date
15 February 2022

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
3605382724
Graduation Year
1968 (58 years ago)
PAC ID
4082800149
Professional Enrollment ID
I20101201000574
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

  • 304, North Talbot Street, Montesano, Grays Harbor County, Washington, 98563, United States

    MONTESANO, WA 98563

    Phone: (360) 249-2243

    Fax: (360) 249-3024

    Type: Mailing

  • Walmart Supercenter, 909, East Wishkah Street, South Aberdeen, Aberdeen, Grays Harbor County, Washington, 98520, United States

    ABERDEEN, WA 98520

    Phone: (360) 538-2724

    Fax: (360) 538-2728

    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.

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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.

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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 98563)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1003918988 uniquely identifies Unknown Individual in U.S. healthcare data.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Montesano, Washington 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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