Unknown Individual – General Practice Physician, NPI 1689789042

Unknown Individual is a healthcare provider. based in Pasco, Washington. specializing in General Practice Physician. They hold a License No. 15368 (OR). The NPI Number for Unknown Individual is 1689789042

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1689789042
Phone
(509) 543-1920
Address
PO BOX 1452
Deactivation Date
4 September 2025

Doctor Profile

Medical School Name
UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Secondary Phone
8082451500
Graduation Year
1983 (43 years ago)
PAC ID
9537243456
Group Practice PAC ID
5092628479
Professional Enrollment ID
I20170525002020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:0State licenses:3Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 1452

    PASCO, WA 993011223

    Phone: (509) 543-1920

    Type: Mailing

  • 515 W COURT ST

    PASCO, WA 993013737

    Phone: (509) 547-2204

    Fax: (509) 542-8836

    Type: Location

  • AFC Urgent Care, 17437, Boones Ferry Road, Cook, Jean, Lake Oswego, Metro, Clackamas County, Oregon, 97035, United States

    SUITE 100

    LAKE OSWEGO, OR 970356201

    Phone: (503) 305-6262

    Type: Location

  • 18470, Ray Ridge Drive, Palisades, Lake Oswego, Clackamas County, Oregon, 97034, United States

    LAKE OSWEGO, OR 970347527

    Phone: (503) 638-0776

    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 99301)

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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: 5092628479View full group profile
NameSpecialtyState
Emergency Medicine, General PracticeOR
O B S T E T R I C S/ G Y N E C O L O G YHI
-HI
Internal Medicine, HospitalistHI
Certified Registered Nurse Anesthetist (Crna)FL
Cardiovascular Disease (Cardiology)PA
O B S T E T R I C S/ G Y N E C O L O G YHI
Orthopedic SurgeryID
A N E S T H E S I O L O G YHI
Internal MedicineHI

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1689789042 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects General Practice Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Pasco, Washington for Unknown Individual; expand the address list for detail.
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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