Unknown Individual – Medical Physician Assistant, NPI 1366430985

Unknown Individual is a healthcare provider. based in Pendleton, Oregon. specializing in Medical Physician Assistant. They hold a License No. 01110 (OR). The NPI Number for Unknown Individual is 1366430985

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1366430985
Phone
(541) 278-3377
Address
17 SW FRAZER AVE
Deactivation Date
19 March 2026
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

  • Bowman Profesional Building, 17, Southwest Frazer Avenue, Pendleton, Umatilla County, Oregon, 97801, United States

    SUITE 282

    PENDLETON, OR 978012163

    Phone: (541) 278-3377

    Fax: (541) 278-2434

    Mailing address matches the actual address.

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 97801)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1366430985?
NPI 1366430985 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Pendleton, Oregon as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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