Unknown Individual – Audiologist, NPI 1043208408

Unknown Individual is a healthcare provider. based in Moses lake, Washington. specializing in Audiologist. They hold a License No. LD1204 (WA). The NPI Number for Unknown Individual is 1043208408

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043208408
Phone
(509) 764-8642
Address
423 W 3RD AVE
Deactivation Date
28 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5096653100
Graduation Year
2002 (24 years ago)
PAC ID
5193743730
Group Practice PAC ID
8325174659
Professional Enrollment ID
I20051102000943
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

  • 423, West 3rd Avenue, Moses Lake, Grant County, Washington, 98837, United States

    MOSES LAKE, WA 988373837

    Phone: (509) 764-8642

    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 98837)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1043208408; it appears in the national provider directory.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Audiologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Moses Lake, Washington because that is what the record indicates for Unknown Individual.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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