Unknown Individual – Clinical Psychologist, NPI 1265586754

Unknown Individual is a healthcare provider. based in Mill creek, Washington. specializing in Clinical Psychologist. They hold a License No. PY 851 (WA). The NPI Number for Unknown Individual is 1265586754

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1265586754
Phone
(425) 742-2400
Address
2012 148TH ST SE
Deactivation Date
26 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4257422400
Graduation Year
1982 (44 years ago)
PAC ID
8325209455
Professional Enrollment ID
I20120416000821
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

  • 2012, 148th Street Southeast, Evergreen, Mill Creek, Snohomish County, Washington, 98012, United States

    MILL CREEK, WA 98012

    Phone: (425) 742-2400

    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.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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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 98012)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1265586754.
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 Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Mill Creek, Washington?
If you are local to Mill Creek, Washington, Unknown Individual may be relevant to your search.
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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