Unknown Individual – Internal Medicine Physician, NPI 1053396226

Unknown Individual is a healthcare provider. based in Walla walla, Washington. specializing in Internal Medicine Physician. They hold a License No. MD00044814 (WA). The NPI Number for Unknown Individual is 1053396226

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053396226
Phone
(509) 529-4850
Address
1027 S HUSSEY ST
Deactivation Date
30 January 2022

Doctor Profile

Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1996 (30 years ago)
PAC ID
1850310988
Professional Enrollment ID
I20051117000243
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

  • 1027, South Hussey Street, Garrett, Walla Walla County, Washington, 99362, United States

    WALLA WALLA, WA 993628279

    Phone: (509) 529-4850

    Fax: (509) 525-5184

    Type: Mailing

  • South 2nd Avenue, Walla Walla, Walla Walla County, Washington, 99362, United States

    WALLA WALLA, WA 993624118

    Phone: (509) 529-4850

    Fax: (509) 525-5184

    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 99362)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1053396226 for Unknown Individual.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Internal Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Walla Walla, Washington?
If you are local to Walla Walla, Washington, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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