Unknown Individual – Registered Nurse, NPI 1053656793

Unknown Individual is a healthcare provider. based in Vancouver, Washington. specializing in Registered Nurse. They hold a License No. 200441597RN (OR). The NPI Number for Unknown Individual is 1053656793

Main info

Organization
Inactive
13 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053656793
Phone
(503) 348-5344
Address
7004 NW LAKESHORE AVE
Deactivation Date
9 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3602536883
Graduation Year
2013 (13 years ago)
PAC ID
1254550411
Group Practice PAC ID
3375837560
Professional Enrollment ID
I20140919002185
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:0State licenses:4Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 7004 NW LAKESHORE AVE

    VANCOUVER, WA 986657044

    Phone: (503) 348-5344

    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 98665)

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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: 3375837560View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWA
C H I R O P R A C T I CWA

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1053656793 is assigned to Unknown Individual under the national enumeration system.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Registered Nurse. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Vancouver, Washington for Unknown Individual; download NPPES for the complete set.
What if Vancouver, Washington seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.