Unknown Individual – Clinical Social Worker, NPI 1578849865

Unknown Individual is a healthcare provider. based in Port angeles, Washington. specializing in Clinical Social Worker. They hold a License No. 60617221 (WA). The NPI Number for Unknown Individual is 1578849865

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578849865
Phone
(360) 457-1610
Address
430 E LAURIDSEN BLVD STE 112
Deactivation Date
8 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3604570431
Graduation Year
2012 (14 years ago)
PAC ID
4183967060
Group Practice PAC ID
7416845870
Professional Enrollment ID
I20191007000625
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 430 E LAURIDSEN BLVD STE 112

    PORT ANGELES, WA 983627978

    Phone: (360) 457-1610

    Fax: (360) 457-8650

    Type: Location

  • 118 E 8TH ST

    PORT ANGELES, WA 983626129

    Phone: (360) 457-0431

    Fax: (360) 457-0493

    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.

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 98362)

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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: 7416845870View full group profile
NameSpecialtyState
Clinical Social WorkerWA
Nurse PractitionerWA
Clinical Social WorkerWA
Mental Health CounselorWA
Nurse PractitionerWA
Clinical Social WorkerWA
Clinical Social WorkerWA
Mental Health CounselorNC
Mental Health CounselorWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1578849865 if you need a stable reference for Unknown Individual.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Port Angeles, Washington for Unknown Individual based on available NPPES addresses.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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