Unknown Individual – Urology Physician, NPI 1174528368

Unknown Individual is a healthcare provider. based in Tacoma, Washington. specializing in Urology Physician. They hold a License No. MD60116291 (WA). The NPI Number for Unknown Individual is 1174528368

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1174528368
Phone
(253) 272-8441
Address
1624 S I ST
Deactivation Date
19 April 2023

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
5097585511
Graduation Year
1990 (36 years ago)
PAC ID
6002814415
Group Practice PAC ID
4082502422
Professional Enrollment ID
I20100327000348

Contacts

Secure Messaging
rzobellagency202174@samhealth.direct-ci.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness85
Years active:0State licenses:4Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 1624, South I Street, G Street Neighborhood, Tacoma, Pierce County, Washington, 98405, United States

    STE 204

    TACOMA, WA 984055092

    Phone: (253) 272-8441

    Fax: (253) 272-8096

    Type: Location

  • 400 Hickory St NW Ste 200

    Albany, OR 973211700

    Phone: (541) 812-5800

    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 98405)

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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: 4082502422View full group profile
NameSpecialtyState
-CO
General SurgeryID
Physician AssistantID
Certified Registered Nurse Anesthetist (Crna)WA
Orthopedic SurgeryID
A N E S T H E S I O L O G YOR
-ID
Certified Registered Nurse Anesthetist (Crna)OR
Interventional Pain Management, AnesthesiologyID
Diagnostic RadiologyNV

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1174528368.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Urology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Tacoma, Washington?
For routing, start with Tacoma, Washington for Unknown Individual, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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