Unknown Individual – Developmental - Behavioral Pediatrics Physician, NPI 1023024627

Unknown Individual is a healthcare provider. based in Portland, Oregon. specializing in Developmental - Behavioral Pediatrics Physician. They hold a License No. MD09531 (OR). The NPI Number for Unknown Individual is 1023024627

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1023024627
Phone
(800) 452-3563
Address
707 SW GAINES ST
Deactivation Date
7 April 2021
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

  • Child Development Rehabilitation Center, 707, Southwest Gaines Street, Marquam Hill, Homestead, Portland, Metro, Multnomah County, Oregon, 97239, United States

    PORTLAND, OR 972392901

    Phone: (800) 452-3563

    Type: Location

  • 14626, Uplands Drive, Uplands, Lake Oswego, Clackamas County, Oregon, 97034, United States

    LAKE OSWEGO, OR 970342754

    Phone:

    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 97239)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1023024627 for Unknown Individual.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Developmental - Behavioral Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Portland, Oregon in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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