Unknown Individual – Emergency Medicine Physician, NPI 1205912581

Unknown Individual is a healthcare provider. based in Portland, Oregon. specializing in Emergency Medicine Physician. They hold a License No. MD18204 (OR). The NPI Number for Unknown Individual is 1205912581

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1205912581
Phone
Not provided
Address
4380 SW MACADAM AVE
Deactivation Date
22 January 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • River Forum Cafe, 4380, South Macadam Avenue, South Portland, Portland, Metro, Multnomah County, Oregon, 97239, United States

    SUITE 570

    PORTLAND, OR 972396403

    Phone:

    Type: Mailing

  • Micro-Pak, 7421, Southwest Bridgeport Road, Tigard, Metro, Washington County, Oregon, 97224, United States

    SUITE 220

    TIGARD, OR 972247711

    Phone: (503) 684-8252

    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.

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 97239)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1205912581.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Portland, Oregon as the reference point for Unknown Individual, then confirm.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.