Unknown Individual – Orthopedic Chiropractor, NPI 1558396242

Unknown Individual is a healthcare provider. based in Lacey, Washington. specializing in Orthopedic Chiropractor. They hold a License No. CH00001743 (WA). The NPI Number for Unknown Individual is 1558396242

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1558396242
Phone
(360) 438-1998
Address
4444 LACEY BLVD SE STE E
Deactivation Date
5 June 2025

Doctor Profile

Medical School Name
PALMER COLLEGE CHIROPRACTIC - DAVENPORT
Secondary Phone
-
Graduation Year
1982 (44 years ago)
PAC ID
0941227755
Professional Enrollment ID
I20051101000095
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

  • The Back Door Bakery, 4444, Lacey Boulevard Southeast, Lacey, Thurston County, Washington, 98503, United States

    LACEY, WA 985035730

    Phone: (360) 438-1998

    Fax: (360) 438-3524

    Type: Location

  • Lacey Spring Post Office, 8975, North Valley Pike, Lacey Spring, Rockingham County, Virginia, 22833, United States

    LACEY, WA 98509

    Phone: (360) 438-1998

    Fax: (360) 438-3524

    Type: Mailing

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

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.

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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 98503)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1558396242 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Orthopedic Chiropractor. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Lacey, Washington.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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