Unknown Individual – Family Nurse Practitioner, NPI 1205895851

Unknown Individual is a healthcare provider. based in Sequim, Washington. specializing in Family Nurse Practitioner. They hold a License No. AP30005349 (WA). The NPI Number for Unknown Individual is 1205895851

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1205895851
Phone
(360) 683-5900
Address
808 N 5TH AVENUE
Deactivation Date
25 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3609632202
Graduation Year
1977 (49 years ago)
PAC ID
9436046422
Group Practice PAC ID
1557256468
Professional Enrollment ID
I20040602000339
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

  • 808, North 5th Avenue, Sequim, Clallam County, Washington, 98382, United States

    SEQUIM, WA 983823045

    Phone: (360) 683-5900

    Fax: (360) 582-4800

    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 98382)

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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: 1557256468View full group profile
NameSpecialtyState
Mental Health CounselorCA
-MD
Certified Registered Nurse Anesthetist (Crna)OK
-WA
Cardiovascular Disease (Cardiology), Internal MedicineWA
Nurse PractitionerWA
Hospitalist, Critical Care (Intensivists)WA
Nurse PractitionerWA
Diagnostic RadiologyWA
-WA

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1205895851 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Washington?
You will see Sequim, Washington on file for Unknown Individual alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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