Unknown Individual – Orthopaedic Surgery Physician, NPI 1245228329

Unknown Individual is a healthcare provider. based in Ilwaco, Washington. specializing in Orthopaedic Surgery Physician. They hold a License No. MD00032030 (WA). The NPI Number for Unknown Individual is 1245228329

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1245228329
Phone
Not provided
Address
PO BOX N
Deactivation Date
4 April 2022

Doctor Profile

Medical School Name
TULANE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3606426498
Graduation Year
1985 (41 years ago)
PAC ID
8224134317
Group Practice PAC ID
7214822105
Professional Enrollment ID
I20070507000354
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

  • Ilwaco, Pacific County, Washington, 98624, United States

    ILWACO, WA 986240319

    Phone:

    Type: Mailing

  • 176, 1st Avenue North, Ilwaco, Pacific County, Washington, 98624, United States

    ILWACO, WA 986249137

    Phone: (360) 642-3747

    Fax: (360) 642-3361

    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 98624)

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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: 7214822105View full group profile
NameSpecialtyState
Nurse PractitionerWA
Nurse PractitionerNMI
Clinical Social WorkerOR
Family PracticeWA
Osteopathic Manipulative MedicineMI
-WA
Physician AssistantOR
Nurse PractitionerNV
Clinical Social WorkerWA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1245228329.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Ilwaco, Washington in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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