Unknown Individual – Family Medicine Physician, NPI 1457380933

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Okanogan, Washington. specializing in Family Medicine Physician. They hold a License No. MD000343559 (WA). The NPI Number for Unknown Individual is 1457380933

Main info

Organization

Inactive

47 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1457380933

Phone

(509) 486-0114

Address

PO BOX 1340

Deactivation Date

24 July 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

5094862151

Graduation Year

1979 (47 years ago)

PAC ID

4082740915

Group Practice PAC ID

9335051150

Professional Enrollment ID

I20100331000047

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 1340
OKANOGAN, WA 988401340
Phone: (509) 486-0114
Fax: (509) 486-0170
Type: Mailing
106, Whitcomb Avenue, Tonasket, Okanogan County, Washington, 98855, United States
TONASKET, WA 988559286
Phone: (509) 486-0114
Fax: (509) 486-0170
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 98840)

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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: 9335051150View full group profile

Name	Specialty	State
DR. PATRICK T. HURLEY (M.D.)	Diagnostic Radiology	MI
DR. CARLTON F ROOS (MD)	Diagnostic Radiology	WA
GEORGE LUPAS	Family Practice	WA
DR. ANDREW JAMES HARRISON (DO)	Diagnostic Radiology	WA
DR. GEORGE ANGELO BIANCARELLI (MD)	Emergency Medicine, Family Practice	MT
DR. DAVID H FREIDENBERG (MD)	Emergency Medicine	WA
DR. KIRK VINCENT MYERS (DO)	General Practice, Diagnostic Radiology, Interventional Radiology	WA
DR. DAVID DONALD TIMM (M.D.)	Diagnostic Radiology	WA
DR. CHRISTOPHER M. KROL (MD)	Diagnostic Radiology	WA
BRANDT CHARLES MOHR (MD)	Diagnostic Radiology, Nuclear Medicine	WA

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?

In the U.S., Unknown Individual is identified by NPI 1457380933.

What happens when Unknown Individual's NPI is not active?

Public data lists Unknown Individual outside the active bucket for this identifier.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.

Which community is linked to Unknown Individual?

Unknown Individual shows a connection to Okanogan, Washington in registry-derived data.

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.