Unknown Individual – Family Medicine Physician, NPI 1114982584

Unknown Individual is a healthcare provider. based in Portland, Oregon. specializing in Family Medicine Physician. They hold a License No. MD24871 (OR). The NPI Number for Unknown Individual is 1114982584

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1114982584
Phone
Not provided
Address
PO BOX 92900
Deactivation Date
7 August 2024
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

  • UHY Crossleys, Station Road, Ballasalla, Malew, Rushen, IM99 6AB, Isle of Man

    PORTLAND, OR 972920900

    Phone:

    Type: Mailing

  • Northwest Council Drive, Twelvemile Corner, Gresham, Metro, Multnomah County, Oregon, 97030, United States

    SUITE 101

    GRESHAM, OR 970303721

    Phone: (503) 665-8176

    Fax: (503) 665-8178

    Type: Location

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.

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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 97292)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1114982584 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Portland, Oregon.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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