Unknown Individual – Radiation Oncology Physician, NPI 1477524841

Unknown Individual is a healthcare provider. based in University place, Washington. specializing in Radiation Oncology Physician. They hold a License No. MD00033187 (WA). The NPI Number for Unknown Individual is 1477524841

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1477524841
Phone
(253) 779-6325
Address
4230 BRIDGEPORT WAY W STE B
Deactivation Date
25 January 2023

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
2532721077
Graduation Year
1985 (41 years ago)
PAC ID
6305823873
Group Practice PAC ID
1658260302
Professional Enrollment ID
I20040701001489

Contacts

Secure Messaging
tacomaradiation@directaddress.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 6509 B, Bridgeport Way West, Harvest Ridge, University Place, Pierce County, Washington, 98467, United States

    UNIVERSITY PLACE, WA 984664335

    Phone: (253) 779-6325

    Fax: (253) 627-8792

    Type: Mailing

  • 1802 Yakima Ave

    SUITE 103

    Tacoma, WA 984054499

    Phone: (253) 272-1077

    Fax: (253) 627-8792

    Type: Location

  • 11511 CANTERWOOD BLVD STE 50

    GIG HARBOR, WA 983325816

    Phone: (253) 851-5155

    Fax: (253) 627-8792

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $46.

Total Amount is formed as General ($46) + Research ($0) + Ownership ($0) = $46.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Astellas Pharma US Inc ($46).

Total Amount

$46

General + Research + Ownership

Payments

3

Total payment records

General Amount

$46

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Astellas Pharma US Inc$46
View all Open Payments →|Open Payments Risk Radar →

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 98466)

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Provider's Procedures

Unknown Individual performs procedures in Radiation Oncology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
RADIATION ONCOLOGYWA77263Management of radiation therapy, complex3938
RADIATION ONCOLOGYWA77300Calculation of radiation therapy dose14727
RADIATION ONCOLOGYWA77427Radiation treatment management, 5 treatments1813

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: 1658260302View full group profile
NameSpecialtyState
Radiation OncologyWA
Radiation OncologyWA
Radiation OncologyWA
Radiation OncologyWA
Radiation OncologyWA
Radiation OncologyWA
Radiation OncologyWA

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1477524841 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Radiation Oncology Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights University Place, Washington; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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