Unknown Individual – Substance Abuse Rehabilitation Facility, NPI 1174016810

Unknown Individual is a healthcare provider. based in Portland, Oregon. specializing in Substance Abuse Rehabilitation Facility. The NPI Number for Unknown Individual is 1174016810

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1174016810
Phone
(503) 783-8770
Address
1305 SE MLK BLVD STE B
Deactivation Date
25 March 2021
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience15
Completeness75
Years active:0State licenses:0Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1305 SE MLK BLVD STE B

    PORTLAND, OR 972143457

    Phone: (503) 783-8770

    Type: Location

  • Southwest Cedar Hills Boulevard, Beaverton, Metro, Washington County, Oregon, 97229-5688, United States

    BEAVERTON, OR 970052020

    Phone: (503) 626-1800

    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.

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 97214)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1174016810 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Substance Abuse Rehabilitation Facility. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Portland, Oregon may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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