Unknown Individual – Emergency Medicine Physician, NPI 1467409318

Emergency Medicine Physician

Unknown Individual is a healthcare provider. based in Aberdeen, Washington. specializing in Emergency Medicine Physician. They hold a License No. MD00041989 (WA). The NPI Number for Unknown Individual is 1467409318

Main info

Organization

Inactive

39 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1467409318

Phone

(360) 537-6113

Address

1006 N H ST

Deactivation Date

1 July 2022

Doctor Profile

Medical School Name

OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

5416673438

Graduation Year

1987 (39 years ago)

PAC ID

4183685050

Group Practice PAC ID

9133033764

Professional Enrollment ID

I20051109000626

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

Grays Harbor Community Hospital East Campus, 1006, North H Street, Bel-Aire, Aberdeen, Grays Harbor County, Washington, 98520, United States
ABERDEEN, WA 985202535
Phone: (360) 537-6113
Fax: (360) 537-6146
Type: Mailing
Grays Harbor Community Hospital, 915, Anderson Drive, Aberdeen, Grays Harbor County, Washington, 98520, United States
ABERDEEN, WA 985201006
Phone: (360) 537-6113
Fax: (360) 537-6146
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 98520)

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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: 9133033764View full group profile

Name	Specialty	State
TAMARA SHANNAN SIMPSON (MD)	Orthopedic Surgery	WA
MICHELLE MCINTYRE	Nurse Practitioner	OR
DR. THOMAS HOLT (MD)	-	OR
MISS PHYLLIS LEPPKE HANSELL (FNP-C)	-	OR
MARY ELIZABETH SWIHART (CFNP)	Nurse Practitioner	AR
MARK MCPHERSON (RN)	Certified Registered Nurse Anesthetist (Crna)	IN
DR. MATTHEW MICHAEL TREINEN (DO)	Diagnostic Radiology	UT
DR. ERIC B TULLEY (M.D.)	Emergency Medicine	CA
DR. DAVID L MACCABEE (MD)	General Surgery	OR
DAVID A WHITE (CRNA)	Certified Registered Nurse Anesthetist (Crna)	ID

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?

Use NPI 1467409318 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 Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.

What location metadata exists for Unknown Individual?

The page summarizes Aberdeen, Washington for Unknown Individual; expand the address list for detail.

Does Medicare enrollment show here?

Medicare enrollment screens are separate from the basic NPI extract shown here.