Unknown Individual – Physician Assistant, NPI 1619353968

Unknown Individual is a healthcare provider. based in Yakima, Washington. specializing in Physician Assistant. They hold a License No. BG60610533 (WA). The NPI Number for Unknown Individual is 1619353968

Main info

Organization
Inactive
11 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1619353968
Phone
(509) 865-2395
Address
601 N KEYS RD
Deactivation Date
31 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5098655600
Graduation Year
2015 (11 years ago)
PAC ID
9234436551
Group Practice PAC ID
4385541986
Professional Enrollment ID
I20160330002591

Contacts

Secure Messaging
hgrau221072@direct.lifespan.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 601 N KEYS RD

    YAKIMA, WA 989011172

    Phone: (509) 865-2395

    Fax: (509) 865-0757

    Type: Mailing

  • 1120 W ROSE ST

    WALLA WALLA, WA 993621662

    Phone: (509) 525-6650

    Fax: (509) 522-2349

    Type: Location

  • 10 DAVOL SQ STE 400

    PROVIDENCE, RI 029034760

    Phone: (401) 421-4000

    Fax: (401) 272-1456

    Type: Mailing

  • 360 KINGSTOWN RD UNIT 200

    NARRAGANSETT, RI 028823258

    Phone: (401) 783-6940

    Fax: (401) 792-3676

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes146123$0
99214Established patient office or other outpatient visit, 30-39 minutes9274$0
G0008Administration of influenza virus vaccine3737$0
87428Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza3030$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit2828$0
View full utilization report →

Insurance plans in this area (ZIP 98901)

Loading plans...

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: 4385541986View full group profile
NameSpecialtyState
Physician AssistantWA
Internal MedicineWA
-WA
-WA
Family PracticeWA
Mental Health CounselorWA
Family PracticeWA
Family PracticeWA
Mental Health CounselorWA
Internal MedicineWA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1619353968 for Unknown Individual.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Yakima, Washington. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

Similar Providers

CARLOS NICOLAS CASO (PA-C)

Medical Physician Assistant
1500 SAN REMO AVE
NPI: 1700852522

MR. LYNN E BRIGGS (PA-C)

Physician Assistant
Summitview Avenue, Yakima, Yakima County, Washington, 98903, United States
NPI: 1871561712

JULIE J DUEIS (PA-C)

Physician Assistant
111, South 11th Avenue, Yakima, Yakima County, Washington, 98902, United States
NPI: 1811957178

ROBERTA A BUUM (PA-C)

Physician Assistant
1806, West Lincoln Avenue, Yakima, Yakima County, Washington, 98902, United States
NPI: 1700830155
Yakima Greenway Trailhead, Yakima Greenway, Union Gap, Yakima County, Washington, 98903, United States
NPI: 1427099613

ISMAEL C. VARGAS (PA-C)

Physician Assistant
6101 Summitview Ave Ste 200
NPI: 1457394470

MR. NORMAN DAVID HAUK (PA-C)

Physician Assistant
Yakima Regional Medical & Cardiac Center, 110, South 9th Avenue, Yakima, Yakima County, Washington, 98902, United States
NPI: 1962447243
266, Massapoag Avenue, Sharon, Norfolk County, Massachusetts, 02067, United States
NPI: 1043255318