Unknown Individual – Family Nurse Practitioner, NPI 1174512891

Unknown Individual is a healthcare provider. based in Spokane, Washington. specializing in Family Nurse Practitioner. They hold a License No. AP30005640 (WA). The NPI Number for Unknown Individual is 1174512891

Main info

Organization
Inactive
26 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1174512891
Phone
(509) 228-1000
Address
PO BOX 3868
Deactivation Date
2 March 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5092281000
Graduation Year
2000 (26 years ago)
PAC ID
1355482209
Group Practice PAC ID
4688561939
Professional Enrollment ID
I20100114000167
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

  • PO BOX 3868

    SPOKANE, WA 992203868

    Phone: (509) 228-1000

    Fax: (509) 252-9300

    Type: Mailing

  • 601, South Sherman Street, Spokane, Spokane County, Washington, 99202, United States

    SPOKANE, WA 992021311

    Phone: (509) 228-1000

    Fax: (509) 252-9300

    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 99220)

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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: 4688561939View full group profile

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1174512891 — the number used across U.S. healthcare to identify this provider.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Spokane, Washington.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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