Unknown Individual – Occupational Therapist, NPI 1164691143

Unknown Individual is a healthcare provider. based in Redmond, Washington. specializing in Occupational Therapist. They hold a License No. OT00003329 (WA). The NPI Number for Unknown Individual is 1164691143

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164691143
Phone
(425) 644-4100
Address
15436 BEL RED RD
Deactivation Date
25 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2064863337
Graduation Year
1998 (28 years ago)
PAC ID
7113240953
Group Practice PAC ID
0143500983
Professional Enrollment ID
I20141230002403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Bel-Red Road, Redmond, King County, Washington, 98052-5491, United States

    STE 100

    REDMOND, WA 980525536

    Phone: (425) 644-4100

    Fax: (425) 644-4101

    Type: Mailing

  • 9617, 7th Avenue Southeast, Everett, Snohomish County, Washington, 98208, United States

    EVERETT, WA 982083710

    Phone: (425) 813-8509

    Fax: (425) 290-9774

    Type: Location

  • 7683 SE 27TH ST STE 254

    MERCER ISLAND, WA 980402804

    Phone: (425) 999-3580

    Fax: (425) 999-3122

    Type: Mailing

  • 1200 112TH AVE NE STE C210

    BELLEVUE, WA 980043740

    Phone: (425) 999-3580

    Fax: (425) 999-3122

    Type: Location

  • 9617 7th Ave SE

    Everett, WA 982083710

    Phone: (425) 813-8509

    Fax: (425) 290-9774

    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.

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 98052)

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Provider's Procedures

Unknown Individual performs procedures in Occupational Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OCCUPATIONAL THERAPYWA97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes19514

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: 0143500983View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeCA
-WA
-CA
-WA
Occupational Therapist In Private PracticeWA
-WA
-WA
Physical Therapist In Private PracticeWI
Physical Therapist In Private PracticeWA

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1164691143 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Occupational Therapist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Redmond, Washington; more addresses can appear in NPPES.
How many locations tie to this NPI?
5 practice locations appear in the available data.

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